Will governors ride to providers' rescue?
James M. Berklan
Now that the U.S. Senate has apparently decided to make healthcare somebody else's problem, I suggest keeping an eye on another pack of politicians: the governors.
Already, a group of 13 state top executives — interestingly seven Democrats and six Republicans — have come together to see if they can build bipartisan momentum behind reform measures.
It's possible these executive branch leaders could reverse-leverage federal legislators to make new law. That kind of shoots holes in the traditional definitions of what the role of each branch is. But let's go with it for now. Others are. Besides, the administration also could institute administrative changes suggested by governors, without Congressional help.
The reason long-term care providers should be so intrigued by the governors is the executive leaders are very much vested in seeing “adequate federal support for Medicaid” survive. Medicaid being the lifeblood of the U.S. nursing home profession, of course.
That's not to say they would ever get everything they want, but as leaders of the “state” part of the state-federal partnership that is Medicaid, they should be a lot less tone deaf to providers' needs.
First, these governors want to stabilize the Affordable Care Act's insurance marketplaces. In short, they want more say over them and the ability to better customize their respective Medicaid programs. Sounds a lot like the administration's goal of putting more power back to the states, doesn't it? Keep in mind that the 13-governor split tilts in the Democrats' favor.
So hope against hope, there might truly be some principled leadership going on here. Crossing the aisle for more than the offertory basket at church is a laudable act.
We should be so lucky. If you haven't noticed already, in recent months there have been extra-high levels of hot air and hollow posturing. Might Sen. John McCain (R-AZ) and Sen. Jeff Flake (R-AZ) have been the starting trickle of defiance that could eventually break a logjam of political tribalism that has thwarted most political proposals lately?
Time will tell, but it is heartening to see that bully pulpit might be being traded favor for something more like a roundtable. There's still a long way to go, though. After all, not one Democrat wavered from party lines during recent Senate voting, and only three Republicans broke ranks — the exact number needed — to scuttle the cockamamie “skinny” GOP bill. That the measure that lawmakers openly said they needed reassurances would NOT be passed into law if they approved it. (Stop and think about that: We'll vote to pass it, but don't you dare make it law.)
If the bold 13 make enough headway, they might get a hearing on Capitol Hill. Where it would go from there is anybody's guess. But if it happens, it would be welcome progress.
They say they'll be meeting for the next 18 months to refine policy proposals. We should all be wishing them well.
Follow Editor James M. Berklan @JimBerklan. Email him at firstname.lastname@example.org.