Capito, Manchin Say They Oppose Health Care Repeal Without Replacement

West Virginia’s Republican U.S. Sen. Shelley Moore Capito said Tuesday that she won’t vote to repeal the Affordable Care Act without a replacement that meets the needs of the people in her state.

All the Senate Republican substitutes drafted so far have failed to adequately address how to keep providing affordable care under the Medicaid expansion, Capito said in a prepared statement.

“I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians,” she said.

Senate Majority Leader Mitch McConnell, acknowledging he lacks support for his latest proposed substitute, said Tuesday that the Senate would vote instead on dismantling much of statute enacted under President Obama. McConnell said that proposal would take effect in two years, giving Congress time to approve replacement legislation.

The Congressional Budget Office has predicted that repeal without replacement would have more immediate impacts, as insurance companies confront uncertainty by raising rates.

About 525,000 West Virginians are enrolled in Medicaid. About 175,000 were able to join when the act expanded eligibility to households with incomes up to about 135 percent of the federal poverty line. About 35,000 others got coverage through the act’s insurance exchange, which has included tax credits to offset premiums for those whose incomes qualify.

“As I have said before, I did not come to Washington to hurt people,” Capito said. “For months, I have expressed reservations about the direction of the bill to repeal and replace Obamacare.”

Repealing the act was a campaign promise of President Donald Trump and many Republican lawmakers, who say an unfettered free market will offer more choices to consumers.

West Virginia’s Democratic U.S. Sen. Joe Manchin has been a vocal opponent of the Republican proposals so far. Like Capito, he has acknowledged that the system needs fixes, especially for the commercial insurance market. Both also support keeping the requirement that insurers cover pre-existing medical conditions.

“It’s very devastating to our nation and our state, the direction this has been going,” Manchin said in a Tuesday conference call.

Manchin also wants more measures to manage the program so that the newly insured are taught to take responsibility for their own health and to obtain care in more cost-efficient ways.

“That’s better than throwing people off and saying, ‘Guess what? I’ve got to save $700 billion so I’ve got to take you people off the roll,’” Manchin said. “That’s not health insurance. That’s not a compassionate way forward.”

Manchin said he’s one of 11 former governors in the Senate who could work in a bipartisan way to find ways to fix the problems. He said he hasn’t yet spoken to Capito about joining in a bipartisan approach, will do so now.