Obamacare sign-ups surge as GOP threatens repeal

Days after the House GOP announced a plan to roll back Obamacare’s expansion of Medicaid, the provision appears to be more popular than ever.

State lawmakers in conservative Kansas advanced a plan Thursday to buy into the Affordable Care Act’s Medicaid expansion, defying Gov. Sam Brownback, who said it would be like “airlifting onto the Titanic” with congressional Republicans trying to cancel new enrollees or shift the financial burdens back on the states.

Legislators, though, said the deal Obamacare offered was too good to pass up.

“Even with the uncertainty to what might happen in Washington, D.C., many of us believe it is the right thing to do,” said state Rep. Steven Crum, a Democrat. “We would expect any change from D.C. to be slow in coming, and we should allow our citizens to get the benefits they deserve.”

Backed by hospital and patient groups, the Kansas House of Representatives voted for the expansion, 81-44.

Mr. Crum said the measure might get through the Senate, though it is unclear if there are enough votes in both chambers to override a veto by Mr. Brownback.

Residents in Maine are also hoping for expansion, filing a petition to put the issue on the state ballot, circumventing Gov. Paul LePage, who has vetoed expansion bills in the past.

Obamacare’s expansion of Medicaid was one of the costliest parts of the health law, promising the federal government would pick up most of the costs for adding those up to 138 percent of the poverty line to state rolls.

More than 30 states have taken the deal, and are now fighting to preserve it even as the GOP in Washington talks repeal.

Ohio Gov. John Kasich said phasing out Medicaid dollars would “phase out coverage” in his state.

The plan House GOP leaders laid out would let states keep their expansions — but would phase out the share of costs covered by the federal government.

That means states like Alaska, Connecticut and California would see their federal funding for the expanded population drop from at least 90 percent to just 50 percent.

House conservatives are itching to scrap the health care law and treat all states the same under Medicaid, particularly those that resisted the money dangled by the Obama administration.

Yet centrist Senate Republicans who represent expansion states will face pressure to safeguard the federal matching funds that enabled their states to cover tens of thousands of needy residents.

“While I clearly have concerns about the expansion’s long-term costs, it has strengthened our native health system and reduced the number of uninsured that are coming into our emergency rooms,” Sen. Lisa Murkowski, Alaska Republican, said Wednesday. “So as long as this legislature wants to keep the expansion, Alaska should have the option — so I will not vote to repeal it.”

Ms. Murkowski said Obamacare has failed overall and led to “crushing premium hikes” on the individual market. Yet she acknowledged that Medicaid expansion is the “elephant in the room” since it allowed at least 27,000 Alaskans to become insured.

A whopping 84 percent of Americans say it is “very” or “somewhat” important for Congress to let expansion states retain their generous federal matching funds, including nearly seven in 10 Republicans, according to a poll released Friday by the nonpartisan Kaiser Family Foundation.

Once Medicaid expansion is phased out, Capitol Hill Republicans want to go even further by capping federal spending on Obamacare through per-capita caps or block grants, saying the current path is unsustainable.

Kaiser’s poll, however, said Americans favor the status quo over each of those options by a 2-to-1 margin.