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PROVIDENCE, R.I. - The White House launched an aggressive drive Friday to persuade key Republican governors to stop criticizing a Senate proposal to overhaul the nation's health-care system, urgently pressuring them in public and private ahead of a decisive week for the controversial legislation.

Despite the administration's sales pitch, however, four influential governors reiterated their concerns about the bill's impact on their states' most vulnerable individuals - underscoring the challenge facing the White House and Senate Republicans as they seek to fulfill a seven-year GOP promise to undo the Affordable Care Act (ACA).

"I've still got to come back to my concerns with regard to the Medicaid population," said Nevada Gov. Brian Sandoval, R, on his way to a private session with Vice President Mike Pence here at the summer meeting of the National Governors Association. Pence had earlier delivered a detailed speech to the entire group defending the bill.

Sandoval's views, along with those of three other governors whose states expanded Medicaid under the ACA - John Kasich of Ohio, Doug Ducey of Arizona and Asa Hutchinson of Arkansas - could prove decisive in determining whether the Senate passes legislation next week. Republican senators from those states are closely watching how their governors respond to the newly revamped legislation as they decide whether to support it.

Kasich, who did not attend, issued a statement calling the revised Senate plan "still unacceptable" because of its Medicaid cuts and possible impact on the private ACA insurance market.

Pence joined Tom Price, President Donald Trump's health and human services secretary, and Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, to work governors in front of cameras and behind the scenes Friday in this waterfront city.

They offered a detailed pitch contrasting with the more general and sometimes contradictory rhetoric Trump has delivered on health care - but one that contained inaccuracies and quickly met with rebukes from health advocates. They claimed, for instance, that the bill would not throw millions off insurance and that disabled Americans have been denied care because of the expansion of Medicaid under the ACA, which is also known as Obamacare.

In his speech, Pence also said the ACA's expansion of Medicaid put "far too many able-bodied adults" on the program.

"I know Governor Kasich isn't with us, but I suspect that he's very troubled to know that in Ohio alone, nearly 60,000 disabled citizens are stuck on waiting lists, leaving them without the care they need for months or even years," said Pence.

The waiting lists Pence referred to apply to Medicaid's home and community-based services, and have not been affected by the program's expansion under the ACA. States have long had waiting lists for these services, and the Henry Kaiser Family Foundation's executive vice president, Diane Rowland, noted that waiting lists in non-expansion states are often longer than in expansion states, which currently receive a 95 percent federal match for their newly covered beneficiaries.

Kasich spokesman Jon Keeling said in an interview that Pence's suggestion that 60,000 disabled Ohioans remain on waiting lists "is not accurate," adding that to suggest Medicaid expansion hurt the state's developmentally disabled "system is false, as it is just the opposite of what actually happened."

"That waiting list is nothing new, and to attribute it to expansion is absurd," said Families USA's senior director of health policy, Eliot Fishman.

Moreover, the expansion population is not solely composed of able-bodied beneficiaries: It includes low-income parents and childless adults, some of whom have chronic illnesses.

The Senate Republican proposal would cut $772 billion from Medicaid over the next decade by phasing out the expansion population, and it makes even deeper cuts starting in 2025. By 2036, according to the Congressional Budget Office (CBO), the government would spend 35 percent less on Medicaid than under the current law.

Among the GOP senators who have questioned aspects of the Senate proposal, at least half a dozen hail from Medicaid-expansion states. Pence, a former governor of Indiana, expanded Medicaid in his state.

Under the Senate bill, roughly 15 million Medicaid recipients would lose coverage within a decade, according to the CBO, which is expected to provide an updated score on the revised legislation next week. But Trump officials are arguing that the administration can cushion the bill's financial blow to the states through a combination of legislative provisions and administrative measures.

In a departure from the president, who often has seemed to have little grasp of health policy details and the effect of them on everyday people, Pence delivered a speech in which he recounted stories of individuals he has met across the country who he said have been harmed by the ACA.

He named a Kentucky small-business owner who he said was struggling under increasing premiums, a disabled Ohio woman who he said lost her plan and doctor, and a Wisconsin grandmother who he said had to choose between paying for coverage and buying Christmas presents.

At least one Republican governor may have been swayed by the pitch: Tennessee Gov. Bill Haslam.

Haslam, whose state did not enter into the expanded Medicaid program, nonetheless had some concerns about the Senate legislation's impact on Tennessee, but he said he came away feeling better about the bill after hearing from administration officials.

"I definitely feel more positive about it," he said. "I was generally much more favorably impressed than I expected to be. They had a lot better story to tell than I thought."

GOP leaders have no margin for error as they seek to persuade several wavering senators to embrace the Senate plan. With the vice president prepared to cast the tiebreaking vote, 50 out of 52 Republican senators would have to approve the measure for it to pass.

Two already have said they object to voting on the bill in its current form: conservative Rand Paul of Kentucky and centrist Susan Collins from Maine. A third, Sen. John McCain, R-Ariz., said Thursday that the proposal did not address the concerns his governor has raised and that he would seek to change it.

Ducey met with Pence and his colleagues but said he still has reservations about the Senate bill. "It needs work," he said. "We're communicating with Senator McCain. We've given him specific language that we think will dramatically improve the bill, and the ball's in the Senate's court."

Until now, the White House has taken a largely hands-off approach to the Senate process, although Trump has said he would be "angry" if the bill fails and compared the effort of brokering a deal in the Senate to the quest for Mideast peace.

Sandoval, who is very popular in Nevada and whose reservations helped prompt Sen. Dean Heller, R-Nev., to come out against the original measure before the July Fourth recess, reiterated his dislike of the latest version of the bill as he made his way to an early meeting here Friday.

"My position has been consistent all along with regard to protecting the Medicaid expansion population," he said. "For Nevada that means 210,000 lives. I want to ensure that their health care is protected, so they can lead healthy and happy lives."

He said he had not spoken with Heller since Senate leaders unveiled their newest iteration of the legislation but hoped to have a conversation with him on Friday.

Kasich was more scathing in the statement he released before Pence spoke, saying the measure's "cuts to Medicaid are too deep and at the same time it fails to give states the ability to innovate to cope with those reductions."

"It also doesn't do enough to stabilize the insurance market, where costs are rising unsustainably and companies are simply dropping coverage," Kasich added.

Hutchinson welcomed some of the changes Senate Majority Leader Mitch McConnell, R-Ky., made to the bill after weeks of consultations with elected officials. He described "some very significant improvements to the bill," including additional funds to help middle- and lower-income Americans buy private insurance.

But in an interview after Pence's speech - and before a scheduled meeting with the vice president - he said the Senate bill remained a "deep concern" to him "in terms of the cost shift we see to the states under the reduced growth rate for Medicaid spending."

Hutchinson said he has spoken to Sen. Tom Cotton, R-Ark., "continually" about the bill, which he said is "moving in the right direction." But he said he was not ready to support it yet.

The latest draft of the bill adds $70 billion to a $112 billion state stabilization fund to be used over the course of a decade for several purposes, including helping consumers pay for insurance. It also changes the amount of funding each state receives under the Disproportionate Share Hospital program to be calculated off the state's uninsured rate, rather than its Medicaid enrollment.

Hutchinson said that he had asked for both those changes, as well as one that would allow states to include their Medicaid-expansion population in any calculations for future block grant funding of the program.

Sandoval said the stabilization fund - which Verma has been touting to Republicans from Medicaid-expansion states as a mechanism for minimizing the number of newly uninsured people - is an intriguing idea. But he was not sold yet.

"On its surface it sounds like it could be a good thing," said Sandoval. "But, you know, at the end of the day, I've got to see what it means in 2020 all the way to 2026."

Fishman's group did an analysis Friday showing that even if the entire fund was used over eight years, it would not cover insurance for the 11 million individuals who stand to lose their existing coverage. "The numbers just don't add up," he said.

Kasich, who has been working behind the scenes with both Republican and Democratic governors, criticized Senate leaders' decision to focus exclusively on passing a bill with only Republican support.

"These shortcomings flow from the fact that the Senate plan commits the same error as Obamacare - it's not bipartisan," Kasich said. "We can still fix this and repeal and replace Obamacare with ideas that will work, but it means having leaders from both sides sitting down together and working in good faith on solutions that responsibly manage Medicaid and stabilize our insurance market."

Early Saturday morning, Price and Verma will speak at a governors-only breakfast on the future of health-care. Later, White House budget director Mick Mulvaney will speak at a legislative briefing.

Asked Friday whether he could support the measure without the changes he has proposed, Ducey said, "I think they're deliberating. So let's let them deliberate."

- - -

Eilperin reported from Washington. The Washington Post's Abby Phillip in Washington contributed to this report.

Published: July 15, 2017 9:09 AM EDT

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Republican governor calls VP Pence's health care claims 'false' - Philly.com

A spokesman for Ohio Gov. John Kasich called out Vice President Pence Friday for saying that Obamacare impacted waiting lists for people with disabilities.

Pence, speaking at the National Governors Association summer conference in Providence, R.I., said that "far too many able-bodied" adults were placed in Medicaid under Obamacare.

"I know Gov. Kasich isn't with us, but I suspect that he's very troubled to know that in Ohio alone, nearly 60,000 disabled citizens are stuck on waiting lists, leaving them without the care they need for months of even years," Pence said. The vice president has been making a case for a Republican healthcare bill that would repeal parts of Obamacare, which would also make changes to Medicaid.

Kasich spokesperson John Keeling shared links about Pence's claim on Twitter and called it "#FakeNews."

"There is zero connection between those asking for support services and Medicaid expansion," Keeling said in an emailed statement. "In fact, after we expanded, the governor signed into law the largest investment in the system for the developmentally disabled in the history of the program, $286 million. To say Medicaid expansion had a negative impact on the developmental Disabilities system is false, as it is just the opposite of what actually happened."

John Weaver, who was a campaign consultant to Kasich when he ran for the GOP presidential nomination, shared a Columbus Dispatch story about the claim and wrote," C'mon @VP You claim to hate Fake News or just hate getting caught spreading it."

A spokesman for Pence, Marc Lotter, pushed back against Weaver, tweeting that the waiting list reference came from an editorial in the Wall Street Journal and shared a link to the piece. Weaver later blocked Lotter on Twitter.

The current structure of Medicaid in expansion states has led to charges from Republicans that able-bodied people are being prioritized in the Medicaid program rather than people who are disabled, who would have qualified before Obamacare but still receive a lower federal match than people covered under expansion. The waiting lists to which Pence was referring apply to home and community-based services, and states had waiting lists before Obamacare was enacted.

Kasich, a Republican, has been a fierce defendant of Medicaid expansion, and Sen. Rob Portman of Ohio is undecided on how he will vote for the bill. Senate Republicans on Thursday unveiled the latest version of their healthcare bill, the Better Care Reconciliation Act, aimed at repealing and replacing parts of Obamacare, and governors remain an influential voice in the healthcare debate. Pence, Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma attended the NGA conference to encourage governors to support the healthcare plan.

The Senate bill's changes to Medicaid, which covers low-income people, as well as children, people who are disabled, and adults in nursing homes, have been particularly controversial. The bill would roll back Obamacare's expansion of Medicaid in states that allowed coverage to go to all low-income residents. Over the long term it allows states to choose between receiving a fixed amount of federal dollars from Medicaid as a per-capita cap or a block grant and reconfigures the program's growth rate to match overall inflation rather than to its current, faster-increasing medical inflation. The Congressional Budget Office estimates that these changes would result in cuts of $772 billion in federal spending on Medicaid, and would shed 15 million people from the program.

Kasich issued a statement about the healthcare bill saying it was "still unacceptable" because of the changes it makes to Medicaid.

Still, Medicaid expansion hasn't been without controversy in Ohio's state government. The Ohio legislature sent Kasich a bill last month asking to freeze the expansion because the state is struggling to take on some of the costs as part of its overall budget. Kasich vetoed the bill.

Pence also had expanded Medicaid when he was governor of Indiana, but did so through a waiver program that included premium contributions and work requirements.

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John Kasich spokesman calls out Mike Pence comments on Medicaid - Washington Examiner

For many Republicans in Donald Trumps Washington, Vice President Mike Pence has been the ax behind the glass youre supposed to break in case of emergency: solid, sharp, and there to save you when the place is going up in flames.

Now, as the Trump White House has become engulfed in one media firestorm after another, Pence is bringing in a new chief of staff, a veteran political operative who Pence loyalists expect will help him manage one of the thinnest, highest tightropes in Washingtonbalancing the vice presidents need to be loyal to a president who requires it, while keeping his own brand and capital strong enough to stand on its own.

The man on the way to fill that role is Nick Ayers, a 34-year-old political consultant who has helped more than a dozen top Republicans in around the country launch, rescue, or cement their political careers, including Mike Pence.

If Ayers name is new to casual observers, it isnt all new to anyone working in Washington. In 2007, Ayers burst onto the scene as the 24-year-old executive director of the Republican Governors Association. But his political break came even earlier, when Ayers, then 19,hit it off with a longshot candidate for Georgia governor named Sonny Perdue. Perdue hired Ayers as his driver, and then won the governors mansion a year later.Four years later, Ayers ran Perdues successful reelection in 2006 and then went with Perdue to the RGA, when the Georgia governor helmedthe committee tasked with electing Republicans to governors mansions.

During Ayers four years at the RGA, success and attention followed. The Washington Post called him Washington's youngest important operative. Some of his fellow young conservatives, like Matt Lewis, called him the most hated campaign operative in America, complaining that young Ayers track record didnt warrant the hype.

But after two full cycles with Ayers running daily operations at the RGA, Republicans went from holding 25 governors mansions in 2007 to 32 in 2011. Among the pick-ups were Scott Walker in Wisconsin, John Kasich in Ohio, Rick Scott in Florida, and Rick Snyder in Michigan. It was also the period when Nikki Haley won her first term in South Carolina and Chris Christie pulled off an upset in New Jersey.

Its hard to overstate how dramatic it was that he was in this position at that age, said Nathan Daschle, a Democratic lobbyist who was the executive director of the Democratic Governors Association when Ayers ran the RGA, when the two became rivals and friends.

In Nick, Mike Pence will get a very savvy and aggressive political mind, Daschle said. Hell also get intense loyalty. He wont have to worry about Nick and that hes got 100 percent loyalty out of his top person.

With the successful run at the RGA under his belt, Ayers left Washington and became a campaign consultant and media buyer. His highest-profile race was also his biggest bombTim Pawlentys spectacular presidential flameout, which ended abruptly five months after it began. Although Pawlenty initially said he dropped out because he lost the 2011 Iowa straw poll to then-Rep. Michele Bachmann (and even Rep. Rand Paul), the Pawlenty campaign was essentially brokewith $450,000 in debt still on the books two months after he dropped out.

A series of lower-profile Senate and governor's races put Ayers on a winning streakrunning outside PACs or advising campaign operations for Sens. Ted Cruz in Texas, David Perdue in Georgia, Tom Cotton in Arkansas, Gov. Bruce Rauner in Illinois, Gov. Eric Greitens in Missouri, and, importantly, the 2016 reelection effort for Gov. Mike Pence in Indiana.

Pence had met Ayers while he was at the RGA and signed him up for his 2016 bid, but Ayers started early after a 2015 religious-freedom bill in Indiana both ignited controversy in the state and took Pence from a 62 percent approval rating to a number in the mid-40s.

When Gov. Pence was looking for outside consulting help, his team talked extensively with Nick, said Bob Grand, a longtime Pence adviser and Indianapolis lawyer. All of us were very impressed, at a young age he has great insight. And I think the governor, now vice president, was very comfortable with his style and his advice.

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Ayers was already working for Pence when the call came to assess the governors interest in joining Donald Trump as his running mate.

Nick was intimately involved in that process, said Grand. A lot of things changed for all of us in a fairly quick period of time and Nick ended up very quickly in a very good role for the vice president.

That role, initially, was as an outside adviser and sounding board for Pence and a board member of the super PAC supporting the Trump administration's agenda, including an attack ad against GOP Sen. Dean Heller over his refusal to negotiate to support the GOP health-care bill.

He came back to the table, a Republican operative observed of the ad, which GOP senators groused about.

Ayers also recently helped Pence launch his own leadership PAC and has been helping Pence host dinners for major donors at the vice presidents residence.

And although he seriously considered a run for governor of Georgia himself, according to The Atlanta-Journal-Constitution, Ayers role with Pence continued to grow as the scrutiny on all members of the Trump administration ratcheted up.

While Pence has remained mostly on the sidelines of the Russia investigation, he has twice insisted in media interviews that no Trump associates ever met with Russians during the 2016 campaign for president.

All the contact by the Trump campaign and associates were with the American people, Pence wrongly told Fox News Chris Wallace.Pence was also at the center of dismissal of former National Security Adviser Michael Flynn, after Pence defended Flynn publicly as having no Russian ties, only to learn weeks later that that, too, was false.

Paul Bennecke, the executive director of the RGA, said having Ayers on the inside of his vice-presidential operation should help both Pence and Trump by having someone on point to execute on their agenda.

I think its a great asset to the president and the vice president to have someone who can figure out what the big objectives are, but more importantly, figure out what they can control and achieve, so that those objectives become reality.

Former Mississippi Gov. Haley Barbour, who was the RGA chairman during much of Ayers time there, said Ayers will also be an important point of contact inside Pences operation for the governors and senators hes worked with before.

Obviously a lot of people will find Nick to be someone theyre comfortable going to share their views.

Going forward, veterans of past White Houses that were similarly under the microscope said Pences toughest, and most important, job might just be staying focused on his actual job and staying out of the West Wing intrigue as much as possible.And thats where the chief of staff comes in.

David Thomas, an aide to then-Vice President Al Gore at the height of the impeachment of President Bill Clinton, said Gores chief of staff directed the staff daily to do your job and say and do nothing related to the impeachment.

Its hard enough to work for a White House in crisis, Thomas said.But if the White House also has internal battles, you wont get through it. Thomas also said the best play for Pence and his team at this point is to keep their heads down and themselves out of the spotlight.

Ayers, who will start officially at the end of the month, declined to be interviewed for this article.

Original post:
Pence Hires Fixer Chief of Staff as Trump Falls Apart - Daily Beast

Vice President Mike Pence quickly moved to distance himself from Donald Trump Jr. this week after a series of bombshell reports found the presidents eldest son had met in June 2016 with a Russian lawyer in an effort to obtain damaging intel on presidential rival Hillary Clinton.

Pences spokesman Marc Lotter sought Wednesday to increase that separation during an interview on Fox News but refused, repeatedly, to say if the vice president had met with any Russians himself during the presidential campaign.

Lotter, appearing on Fox News Americas Newsroom, was asked several times by host Bill Hemmer if his boss ever met with representatives from Russia or representatives from the Russian government during the campaign.

Clear up a few things for us now. Did the vice president ever meet with representative from Russia? Hemmer asked.

The vice president is not focused on the areas where, you know, on this campaign, especially things that happened before he was even on the ticket. As he has said, that when he joined the campaign his entire focus was on talking to the American people, taking the case that President Trump was going to make to the American people, Lotter replied, saying Pence was focused on the administrations agenda.

The message echoed that ina curious media statement released by Lotter on Tuesday as the Trump Jr. story snowballed.

The vice president is working every day to advance the presidents agenda, the statement from Pences office, attributed to Lotter, said. He was not aware of the meeting. He is also not focused on stories about the campaign especially those pertaining to the time before he joined the campaign.

Hemmer, not to be deterred, asked again: I understand. Fully aware of the statement there. Just come back to this question here: If it wasnt a private citizen from Russia, did he ever meet with representatives from the Russian government during the campaign?

That stuff, the special prosecutors and the counsels are all looking at, Lotter said, before saying once again that Pence was focused on other things during the campaign.

Hemmer tried one last time. Just to nail this down so were clear: Is that a yes or a no? Did he or did he not, and was it relevant, in fact?

Lotter offered a quick reply, saying, Im not aware of anything that I have seen, before again launching into a defense of Pences activity working the agenda that people sent him to Washington to accomplish.

Pence in January denied that anyone on the Trump campaign had ties to Russian officials.

Well, of course not, he told CBS John Dickerson then. And I think to suggest that is to give credence to some of these bizarre rumors that have swirled around the candidacy.

Excerpt from:
Mike Pence's Press Secretary Won't Say If His Boss Met With Russians - HuffPost

By Haley Samsel and Maria Carrasco | 3 hours ago | Updated 59 minutes ago

Vice President Mike Pence addressed high school students in Kerwin Hall on Wednesday.

Vice President Mike Pence delivered a speech at AU Wednesday morning to high school students attending the National Student Leadership Conference (NSLC), provoking outrage from AU students online and a small protest outside the speaking venue.

The event was not affiliated with the University, said AUs Assistant Vice President of Communications Camille Lepre.

NSLC is hosting the vice president as part of its annual conference which offers participants an opportunity to experience a week of activities on a college campus. This is not an AU-affiliated event and is not sponsored by the university, Lepre wrote in an email to The Eagle.

Pence delivered remarks in Kerwin Hall as part of the conference, which offers science, journalism and public policy programs to high school students, according to its website. NSLC holds leadership programs at 11 universities across the country, including AU. An email to the NSLCs program office at AU was not answered as of press time.

Its really great to be here at American University to address a rising generation of leaders in America. Give yourself a round of applause. You are the future, Pence said in his speech.

Pence gave advice to students on the skills they need to be leaders, telling them to expect and learn from criticism and to keep persevering. He spoke about a moment he shared with President Trump, remarking on Trumps listening skills.

The truth is our president leads by asking questions and he listens, and I believe that reflects the type of humility that will enhance your ability to be a leader, Pence said during his speech.

While this event was not sponsored or affiliated with AU, students protested the event online and in person. Several students spoke out online against Pences history of opposing LGBT rights, such as the legalization of gay marriage.

On Facebook, a copy and paste post was shared by dozens of students, reading: I, [name], condemn Mike Pence speaking at American University. He does not reflect our core values regarding reproductive justice and supporting the LGBTQIA+ community. #AUProtestsPence. Please copy/paste/fill in your name and tag American University to let them know where our community stands.

Recent AU graduates Quinn Dunlea and Dan Perry, along with senior Toby Jones, took their act of protest to the steps of Kerwin Hall, holding signs that read AU students dont stand by and say nothing and Religious freedom Discrimination. While there were less than a dozen students there, Jones said it was important for students to have their voices heard.

If there was any time for AU students to make ourselves known about where we stand on Mike Pences policies and his rhetoric that hes been using, now is that time, when hes coming to our campus, Jones said at the protest. And even though its not through AU, its an important event that hes coming to our campus and its important that we let him know how we feel.

Though the group gathered outside Kerwin Hall was small, it did include a recognizable name: Student Government President Taylor Dumpson.

Im here as student government, to make sure students that are protesting are aware of their rights that theyre afforded through the student code of conduct, Dumpson said at the protest. As well their freedom of expression and dissent and also making sure that theyre aware of the resources available with CASE [Center for Advocacy and Student Equity].

Senior and AU Ambassador Mark Sullivan, who could not attend the protest due to work, was also upset about Pences appearance and posted on Facebook that he would be wearing a rainbow pin as he gave tours of campus on Wednesday. Sullivan said he felt compelled to speak out against Pences speech on AUs campus as a member of the LGBT community.

As an ambassador at AU, I talk about what an incredible and supportive community I have found in my three years here, and the fact that we had Pence speaking on a campus that boasts about its inclusion and its diversity is something that shouldnt be ignored, Sullivan said in a message.

While several students expressed their distaste for Pences appearance, the AU College Republicans released a statement in support of the event.

The AU College Republicans could not be more elated to hear that Vice President Pence chose to visit American University per the invitation of a private organization. It is always an honor to have nationally significant figures on our campus, and it is especially laudable to host the vice president of the United States who has proven himself to be a strong conservative throughout his career as a public official, the statement read.

Sullivans problem with Pences appearance did not have to do with Pences identity as a Republican or a conservative, but with Pences ability to push his ideas onto a community he doesnt interact with, Sullivan said. He is worried about the consequences of Pences appearance on campus.

While [Pence] wasnt speaking to AU students, he was speaking to high schoolers that are part of a summer program and I hate the idea that they will associate Mike Pence with AU because I dont feel like he represents the overall student body or the campus culture, Sullivan said.

mcarrasco@theeagleonline.com and hsamsel@theeagleonline.com

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Mike Pence speaks at AU, sparking objections from students - The Eagle