JUDY WOODRUFF: But, first, let’s turn to the Senate Republican bill to overhaul parts of Obamacare.
The Senate may be in recess this week, but Majority Leader Mitch McConnell is working behind the scenes to craft a bill that will appeal to enough Republican votes to pass.
One of the key stumbling blocks, the provision to cut Medicaid spending by more than $770 billion over 10 years. That has sparked serious concern among many governors, among other reasons, over what it could mean for opioid abuse treatment and related health needs.
The Medicaid expansion under the Affordable Care Act provided new coverage to many. Reportedly, Senator McConnell has been considering a $45 billion fund to deal with opioid abuse.
New Hampshire is one state that is dealing with a crisis. It has the second highest rate of opioid deaths relative to its population.
I spoke with the state’s Republican governor, Christopher Sununu, a short time ago, and started by asking him why he doesn’t support the current Republican Senate proposal.
GOV. CHRIS SUNUNU, R-N.H.: Well, I think it’s important to start off by understanding that Obamacare has failed, it is not sustainable, it is not affordable. Specifically here in New Hampshire, the health care exchange is really on the brink.
We’re looking at upwards of 40 percent cost increases to individuals. That’s just not affordable to anyone. So, I do applaud the Senate and the House’s efforts and the Trump administration’s efforts to really take Obamacare as a reform that has to happen.
That being said, what they’re really doing here is, they’re kind of conflating two issues. They’re looking at Medicaid, traditional Medicaid entitlement reform, which absolutely has to be a viable discussion in Congress, and Obamacare reform. And they’re really putting the two together. That’s the end result there.
The cost implications, if you will, are really drastic to the state of New Hampshire. You’re looking at over $1.5 billion at best over the next 10 years. That’s not just a challenge for us in the state. It’s not practical. It’s just not practical at all.
We have no sales tax, we have no income tax. We don’t have the taxes to raise, nor would we ever want to, like other states do. So we have to find a better solution there.
So I commend them for taking up the challenge. But right now, as it sits, the Senate plan is not a viable solution for this state.
JUDY WOODRUFF: So, Governor, specifically with regard to the opioid use crisis in your state of New Hampshire, what would this bill, this proposal mean for that?
GOV. CHRIS SUNUNU: Well, we have been on kind of ground zero, if you will, for the opioid crisis.
We have one of the fastest growing economies, one of the best qualities of life. Because we are a small state, that allows us to be very innovative in our approach. And so we have been able to sustain great success in the state, in spite of the opioid crisis.
But part of that, when you look whether it’s Medicaid expansion or other programs that have allowed individuals to get care, recovery services, medical care that they otherwise may not have — would have been able to receive, that has been a big boon for our state and it’s been a big boost to those individuals and allowed those doors to be opened to them in ways that otherwise it wouldn’t have.
So, when you look at both the cost implications, how Medicaid expansion right now as it’s proposed to being winnowed down, if you will, over the next few years, again, those costs are real severe and they’re again something that just is not practical for the state of New Hampshire.
JUDY WOODRUFF: What would it mean to the program that you have in place now in New Hampshire?
GOV. CHRIS SUNUNU: Well, when you look at folks that are coming through recovery or treatment or folks that are looking to fight that addiction, you have remember addiction with opioids is not something that you get through in a couple of years.
It’s a lifelong struggle. It’s a lifelong kind of battle, if you will, that folks have to have the programs in place not just for six months or a year, but for the long-term. And we have to have those recovery programs. We have to have those treatment options in place.
With opioid addiction comes some very severe medical conditions as well, whether liver or heart issues that come with that. Right now, we’re able to treat those. We’re able to be preventative with a lot of those, as opposed to just allowing the old way of doing things where everyone would just pile into the emergency room.
So, going back, taking instead of one or two steps back, but three or four steps back, all the way to the point where we’re cutting services that, pre-Obamacare, were in place, right, we’re looking for a system that, for New Hampshire at least, is worse than there were even pre-Obamacare.
So my message to the Senate is very clear. Look at Obamacare reform as is. Look at that program, what we can do to reform it. Understand that the opioid crisis is affecting a lot of states, not just New Hampshire. Understand what those implications might be.
It’s not just in the funding, but it’s in the flexibilities that states have to have.
JUDY WOODRUFF: Right.
GOV. CHRIS SUNUNU: You have to have a flexible system.
And being able to do that will allow us as governors to implement the programs that much easier.
JUDY WOODRUFF: Now, it’s been reported, as I think you know, that the Senate majority leader, Mitch McConnell, is looking at possibly adding something like $45 billion to deal with opioid abuse around the country over a period of years.
Would that make a difference?
GOV. CHRIS SUNUNU: When you look at $45 billion to deal with the opioid crisis, absolutely that’s going to make a difference. There’s no doubt about it.
If it’s money going in to kind of hopefully get votes in the Senate bill, that’s a different issue. I’m not going to sign onto that. But there is no doubt that more resources would help this crisis. It allows recovery centers to have more longer-term programs, open up treatment options.
We can break down some of the permitting process to get more of those beds open for individuals, peer-to-peer recovery services. We have been able to be very, very innovative here in New Hampshire, really on the cutting edge. And that’s how we have been able to sustain such a growing economy, such a high quality of life, in spite of the crisis.
We don’t want to start throwing a wrench in those gears right now and slow down the incredible process we have been able to make in New Hampshire.
JUDY WOODRUFF: I ask you about that money because specifically other governors, I know John Kasich of Ohio and others who have an opioid crisis in their own states, have said that’s just not enough money to make a difference over a long number of years.
GOV. CHRIS SUNUNU: Well, as I said earlier, you know, this is something that is not going to get solved in the next couple of years. It is going to be a lifetime issue for a lot of these folks.
We have to have lifetime-style programs in place to kind of ease them not just off of the opioids they’re in, making sure they have peer-to-peer support recovery programs, making sure they can enter the work force and hopefully get on better private insurance plans, as opposed to just relying on expanded Medicaid or the health care exchange.
So, when you’re able to create systems that work efficiently — I’m an engineer by trade. I’m all about creating an efficient system. When you’re able to do that and implement that, there is a lot of savings you can have on the back end.
I do believe dollars can help. There’s no doubt about that. But when you look at the total implication of this Senate bill, $1.5 billion at best over the next 10 years, I don’t mean to sound glib, but $45 billion here and there really isn’t making the dent and really making the long-term effects that we have to be addressing as part of a long-term Medicaid reform.
JUDY WOODRUFF: Governor, one other thing, the argument that the Republicans in Congress have made on Medicaid and that is — and the president’s budget director, Mick Mulvaney, has said Medicaid is unsustainable on the path that it’s on now, it’s grown way too expensive, it cannot continue like this, cuts have to come, there has to be a change in the trajectory.
GOV. CHRIS SUNUNU: Well, look, I would absolutely agree with that.
Look, Washington is dealing — the Senate and the House and the president are dealing with nearly $20 trillion in debt. That is real money owed to someone, and a lot of it oversees.
So, our spending over the last eight years has gone completely out of control. And so they do have the challenge ahead of them of reeling that spending back in, creating more efficient systems.
Reeling it in is one thing. Going above and beyond from even where we were eight years ago is another story. And that’s where we kind of draw the line and say, look, let’s deal with Obamacare here, let’s deal with Medicaid entitlement reform in another discussion, another discussion that frankly has to probably be a longer discussion, have to really get the input from the states, nothing that should be rushed.
So if we can deal with those two issues separately, I think we can have just much better outcomes and a much more viable solution for all the states.
JUDY WOODRUFF: Governor Chris Sununu of New Hampshire, thank you very much for talking with us.
GOV. CHRIS SUNUNU: Thank you, Judy.