What Trump Calls "Great," All 50 State Directors of Medicaid Say Is Terrible

With nearly unheard of consensus, and despite assurances from serial liar President Donald Trump that the bill is actually "great" and would "help people," all 50 state Medicaid directors have signed on to a letter denouncing Republicans' latest effort to repeal the Affordable Care Act (ACA).

"Our members are committed to ensuring that the programs we operate improve health outcomes while also being fiscally responsible to state and federal taxpayers," reads the letter (pdf) published Thursday by the National Association of Medicaid Directors (NAMD).

"We are concerned that this legislation would undermine these efforts in many states and fail to deliver our collective goal of an improved healthcare system," it continues, outlining why the Republicans' proposal, coauthored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), is flawed and echoing concerns that Congressional Budget Office will not have time to fully analyze the bill's impacts until after the vote planned for next week.

Many others, including Andy Slavitt, who ran the Centers for Medicare and Medicaid Services under former President Barack Obama, expressed similar surprise about the joint letter. "Very unusual," Slavitt said in a tweet.

The legislation would halt Medicaid expansion and restructure how it receives federal funding, implementing a block grant system that the directors caution "would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country's history."

The plan would require states to craft their own programs by January of 2020, which the directors claim would be next to impossible, "especially considering the apparent lack of federal funding in the bill to support these critical activities."

"With only a few legislative days left for the entire process to conclude," the letter declares, "there clearly is not sufficient time for policymakers, governors, Medicaid directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms."

The Medicaid directors join a broad and diverse coalition of politicians, healthcare providers, progressive leaders, late-night talk show hosts, and voters opposed to the GOP's last-ditch repeal effort.