AUGUSTA — Gov. Paul LePage said Thursday that the rush to bring an Affordable Care Act replacement bill to a vote could doom the effort by President Trump and conservatives in Washington.

LePage suggested Thursday that negotiations on the bill moved too quickly and there was not enough compromise.

“It was fairly fast and that’s why I had to go to Washington, two or three times, it was fairly intense and that may be its downfall,” LePage said while speaking with WGAN radio hosts Matt Gagnon and Ken Altshuler during his weekly call-in appearance.

The Republican governor said that Congress must approve a workable replacement for the ACA, known as Obamacare, before it can move on to work on federal tax reform.

“If you don’t fix health care, it’s like education in Maine, until we fix education in Maine we are always going to be a high-tax state,” LePage said. “I believe until you fix health care in America we are always going to be a high-tax country, because it just consumes so much of the budget. You fail to do this, there is very little you can do on the other side.”

The American Health Care Act, the bill some Republicans hope will replace Obamacare, was headed for its first vote Thursday, but the vote was postponed until Friday when it appeared to lack sufficient support to clear even the Republican-controlled House.

In recent weeks LePage has visited Washington to lobby lawmakers and the Trump administration on changes he believes are needed in the bill, including requiring low-income workers who receive Medicaid benefits to pay some of their health costs.

“I’m not suggesting that they have to buy their own but they have to have skin in the game,” LePage said. “Poverty is not a handicap.”

LePage on Wednesday joined a group of Republican governors in a letter to Senate Majority Leader Mitch McConnell, R-Kentucky, and House Speaker Paul Ryan, R-Wisconsin, saying they support the replacement bill following changes made this week.

“The move to a more flexible Medicaid program that empowers states with options to utilize per-capita caps or block grants; providing a workable timeframe for transition out of Obamacare; advancing work requirements to encourage able-bodied Americans to find jobs; and providing states with funds to help stabilize our insurance markets and provide assistance to low-income Americans, are all positive improvements to the bill,” read the letter signed by LePage and the governors of Alabama, Indiana, Kansas, Mississippi and Missouri.

LePage press secretary Adrienne Bennett said Thursday that the governor views the AHCA as a starting point. “I am not insinuating that the governor is saying that this is the one-size-fits-all solution,” Bennett said in an email to the Press Herald. “This is a start. To neglect to do anything is more damaging.”

LePage also wrote U.S. Sens. Susan Collins, a Republican, and Angus King, an independent, Wednesday to urge them to oppose any expansion of federal Medicaid programs for “able-bodied adults without dependents.”

LePage argued that Maine’s 2002 expansion of Medicaid was a financial disaster for the state because it prompted low-income Mainers to drop their employer-based health insurance for free health care under Medicaid. LePage and Republican lawmakers have since tightened Medicaid eligibility for adults without dependent children, removing some 86,000 from state-sponsored health insurance programs.

In his letter, LePage writes that an estimated 100,000 Mainers who now have private insurance would drop it if Medicaid were again expanded to cover them.

“If (able-bodied adults without dependents) around the country are allowed to drop their private insurance and get ‘free’ health care on Medicaid, it will considerably compound the cost of Medicaid expansion and ruin the commercial market,” LePage wrote in his letter to King and Collins.

LePage also reiterated his support for provisions in the ACA that provide subsidies to low-income workers to purchase private health insurance. He noted that while Maine cut Medicaid enrollment for non-disabled adults from 2011 to 2015, the state’s uninsured rate actually decreased as well. Maine’s uninsured rate dropped from 10.7 percent in 2011 to 8.4 percent in 2015, LePage notes.

“That is why I have no objection to continuing a system of private insurance premium assistance for low-income workers,” LePage wrote. In his letter, LePage doesn’t ask Collins and King to support the Republican health bill, but does urge them to support repealing and replacing the ACA.

Meanwhile, Mainers opposed to the repeal urged Congress to reject the House bill Thursday.

During a State House news conference, state Rep. Anne Perry, a Calais Democrat and a family nurse practitioner, said the ACA has provided more Mainers with health coverage, especially for preventative care. Perry said the House bill would once again make health care coverage largely unaffordable for many Mainers, especially older residents who don’t qualify for Medicare.

“If the repeal of this bill passes into law, a 60-year-old resident living in Washington County making $40,000 a year would see premiums rise while their taxes go up,” Perry said. She urged Maine’s 2nd District Congressman Bruce Poliquin, a Republican, to vote against the bill. Collins, King and Maine’s 1st District Congresswoman Chellie Pingree, a Democrat, have all indicated they oppose the current version of the measure.

Ed Saxby, a Cape Elizabeth resident battling cancer, said he would lose his health coverage if the ACA is repealed.

“I can afford the treatment I need, as a retiree, living on a fixed income, because of the tax subsidies provided under Obamacare,” Saxby said. Were those subsidies removed, he would no longer be able to afford the treatments that are keeping him alive, he said.

“There are millions of people in my situation,” he said. “Some of the studies that have been done on this have said if we take away health insurance and that coverage and access to care for 14 million people in the first year, about 45,000 people will die prematurely. I’ll be one of them.”

Maine Democratic Party Chairman Phil Bartlett also issued a statement Thursday criticizing LePage’s letters to Congress. Bartlett said LePage’s apparent support for the House bill as a starting point for ACA reform ignores that the replacement bill could leave more than 100,000 Mainers without coverage.

“The GOP health care bill would be catastrophic for elderly, rural and low-income Mainers,” Bartlett said in a prepared statement. “It is not only laughable that LePage suggests passing the AHCA would be beneficial to Mainers’ ‘economic well-being,’ it is dangerous. The AHCA is bad for Mainers, and to suggest otherwise after weeks of publicly criticizing the bill frankly reeks of kowtowing to White House pressure.”

Scott Thistle can be contacted at 791-6330 or at:

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