Tom Reed

U.S. Rep. Tom Reed meets with the Times Herald editorial board in October. 

U.S. Rep. Tom Reed, R-Corning, expressed concern Monday over how to replace expanded Medicaid eligibility under the Affordable Care Act.

Over the weekend there were reports indicating President Donald Trump favored federal block grants to states to replace Medicaid’s traditional open-ended entitlement. It’s unclear if expanded Medicaid coverage provided under the Affordable Care Act would be included.

In New York, the Affordable Care Act accounted for about $3.7 billion a year for increased Medicaid coverage. A repeal of the act could affect 2.7 million New York residents, according to Gov. Andrew Cuomo.

Reed told reporters during Monday’s weekly press call he thought states could do better under a block grant system for Medicaid, but he wanted to see those who received medical insurance under the Medicaid expansion maintain their access to health care.

“I’m looking to be a voice to potentially strengthen that proposal,” Reed said. “I think we have to do better.”

By phasing out the entitlement requirement of Medicaid and replacing it with block grants to states, it would leave state legislatures and governors to decide whether to cut benefits if federal funding was insufficient.

This will be “a significant part of the health care replacement debate,” Reed predicted of the Medicaid expansion.

The New York congressional delegation has placed the Medicaid expansion as one of its top priorities, Reed said.

“There is a lot of anxiety being created over the debate to repeal and replace” what’s more commonly known as “Obamacare,” Reed said.

Cuomo, in a letter to New York congressmen, outlined the number of residents in each county who stand to lose their coverage if the legislation is repealed by Congress and nothing is done to replace it.

In Cattaraugus County, 8,300 individuals could be affected by repeal of the Affordable Care Act, as well as 4,608 people in Allegany County. Nearly 60,000 residents across the 11 counties represented by Reed could lose their health care, Cuomo’s data shows.  

There are 180 Congress members — Republican and Democrat — in states, including New York, where the act funded the cost of extending Medicaid benefits to families for three years.

Reed said the president intended to send a message for health care market stabilization — providers and insurers — going forward in a stable manner.

Reed has acknowledged he favors some of the more popular aspects of the laws, such as children being on their parents’ policies until age 26, coverage for pre-existing conditions and no lifetime cap. He expects these would be continued, but there is little agreement on what else to include.

With only 51 Senate votes needed for much of the repeal of the act, but 60 votes required for most of what will eventually replace it, Reed indicated some of the votes for replacement may be hard to come by.

Reed acknowledged he was aware the Patient Freedom Act sponsored by Sens. Susan Collins of Maine and Bill Cassidy of Louisiana would permit states to stay with the Affordable Care Act or receive a similar amount of federal money, which consumers could use to pay for medical care and insurance.

Cassidy recently outlined the proposal to Republican Congress members.

“It would give more flexibility to the states,” Reed said — something he supports.

Along with many other Republicans in Congress, Reed said he wants to get to the root issue of getting health care costs under control. It should be accessible and affordable, he added.

While Collins and Cassidy want to get the replacement plan going quickly, the process will unfold as Republicans see how much of the policy can be accomplished with the 51-vote Senate plan. Republicans control 52 of the 100 Senate seats. There are 46 Democrats and two independents who caucus with the Democrats.

Reed acknowledged a protest Monday outside his Geneva district office by senior citizens opposed to cuts in Medicare, which the president had said during the campaign he wouldn’t change.

Reed said one of the Republican “Better Way” proposals would reform Medicare, which he supports.

“We cannot do nothing,” Reed said. “(Medicare) is in need of reform to save it. I’m open to ideas to save Medicare. I want to listen to the American people before passing reforms.”

REED ALSO PLANS to reintroduce his Hand Up Act, which died at the end of the 114th Congress.

It established a framework for demonstration projects that supports individuals and families with the goal of moving them toward self-sufficiency, reducing welfare dependence, and increasing work and earnings.

It would apply to Temporary Assistance for Needy Families, block grants to states for Social Services, activities funded under the Workforce Investment Act, activities funded under the U.S. Housing Act of 1937, and the Supplemental Nutrition Assistance Program.

Reed said the Secretary of Health and Human Services would have the authority to approve demonstration programs designed to get people out of poverty.

It would “recognize that work is to be rewarded, not to be penalized,” he said.

Often when people transition from social services programs and take a job, they lose benefits — like health care or food stamps.

The goal of these programs should be to get people out of poverty, Reed said. The plan would allow for more efficient delivery of welfare programs and the ability to adapt to local needs, he added.

(Contact reporter Rick Miller at Follow him on Twitter, @RMillerOTH)