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    GOP governors fret over Senate health care proposals

    Canada’s Prime Minister Justin Trudeau spoke at the National Governors Association special session called “Collaborating to Create Tomorrow’s Global Economy,” in Providence.
    Ryan Remiorz/The Canadian Press via Associated Press
    Canada’s Prime Minister Justin Trudeau spoke at the National Governors Association special session called “Collaborating to Create Tomorrow’s Global Economy,” in Providence.

    PROVIDENCE — Most of the nation’s governors gathered Friday with an eye on Washington, where Senate Republican leaders are working to cobble together support for a bill repealing and replacing the Affordable Care Act.

    Among Republican chief executives assembled for the national conference, there was loose agreement that they want their Medicaid funding safeguarded and flexibility to work within state-specific budget constraints. And there was a broad consensus of frustration that decisions being made in Washington will have an outsized effect on how they run their own governments.

    Vice President Mike Pence, a former Republican governor of Indiana, sought to whip up support for the bill, offering reassurances to his former colleagues about Medicaid funding and guarantees that their abilities to innovate would not be impeded.


    Declaring President Trump a “champion of federalism,” Pence told governors in a keynote the Senate bill would help “rescue” states as they dealt with the “collapse” of the Affordable Care Act.

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    “As governors, you’re living that reality — not far afield in Washington looking at statistics,” Pence said, promising rolled-back restrictions on states’ individual Medicaid waivers and “unprecedented” flexibility.

    Governor Charlie Baker of Massachusetts has repeatedly raised concerns with congressional leaders that his state could suffer from the House bill and the initial Senate bill that failed to receive support. Senate leaders released a revised bill Thursday, although prospects for that bill are dicey.

    “Governors are anxious to make sure that they have the capacity and ability to make sure they can serve . . . their constituents, in the best way they can,” he told reporters Thursday. Baker did not attend Friday.

    Stephan Savoia/Associated Press
    Governor Terence McAuliffe of Virginia introduced Vice President Mike Pence before Pence addressed the NGA on Friday in Providence.

    “I’m not going to support anything that translates into a taking, literally just a take-back, from the federal government with respect to the commitment they’ve already made to support health care in Massachusetts,” Baker said.


    Trump this week said he would be “very angry” if Congress does not pass a health care bill.

    The biennial, nonpartisan governors’ conferences commonly offer a chance for governors to talk policy, huddle in partisan gatherings, and mingle with corporate sponsors. This weekend, the Rhode Island Convention Center offered complimentary state delicacies: fried clam cakes, Del’s frozen lemonade, and hot dogs.

    NGA officials said 32 governors planned to attend the confab. Most of them — whether they wanted to or not — were talking health care.

    Discussing his Republican colleagues, Governor Mark Dayton, a Minnesota Democrat, said, “The concern I’ve heard from Republican governors is very much the same as concern I have [heard] from [Democrats] because we’re all going to be impacted the same way. We’re going to be overwhelmed with a financial gap.”

    And, as is often the case with state policymakers, edicts from Washington felt too far out of their control.


    “For governors always, whenever Congress is acting, we want to make sure they understand that the states, we’re boots on the ground,” said Governor Matt Mead of Wyoming, a Republican. “And it’s our jobs to make sure the citizens’ safety, welfare, health care are taken care of.”

    Mead said he wants the final bill to recognize the needs of low-population, rural states like his, adding that affordable health care access is a linchpin for the economy there.

    “Any of these things are going to be far from perfect,” he said.

    The most common refrain among GOP governors in Providence on Friday was that they had yet to review Senate leaders’ revised bill released this week.

    One GOP governor that Pence named in his speech, John Kasich of Ohio, preempted the vice president’s speech with a statement criticizing the revised bill. Kasich, who did not attend the National Governors Association conference, said the measure’s Medicaid cuts were “too deep” and that it “fails to give the states the ability to innovate.”

    Ryan Remiorz/The Canadian Press via Associated Press
    Governor Scott Walker of Wisconsin, who met with Prime Minister Justin Trudeau of Canada on Friday, said he’s unsure of the health care bill’s chances of clearing Congress.

    Asked the bill’s odds of clearing Congress, Governor Scott Walker of Wisconsin, chairman of the Republican Governors Association, replied, “That’s hard to tell. I try to stay out of Washington as much as I can.”

    “I would imagine, bottom line is nobody wants to be the vote cast that stops the repeal of Obamacare, and so — whether it’s this or some other way — they’re going to keep coming back, I think, until they get there,” Walker said.

    Even governors unwilling to criticize Trump directly noted consternation that state houses, ultimately, will bear the budget effects of decisions being made in Washington.

    Governor Mary Fallin of Oklahoma, who endorsed Trump late in the primary, said she had picked up “various opinions among the governors, even within political parties” over the bill. Trump won her state by more than 36 percent, and Fallin noted that her state had been reduced to having one insurance carrier offering coverage through the Affordable Care Act exchange.

    Fallin, a former House member, has seen health care policy from both the federal and state angles, voting against the Affordable Care Act as a congresswoman and, now, implementing it as governor.

    “I’ve been on both sides,” she said. “I voted against it, but yet here I am having to work with the bill itself and the federal rules and regulations.”

    Governor Kay Ivey, Republican of Alabama, also represents a state with only one provider in the online marketplace.

    “Ultimately the decisions, I hope, will be left up to the states because we can do things with flexibility that meet the quality and needs of our people,” Ivey said. “It will still be an awesome challenge, but sometimes it is better for the states to make these decisions instead of the federal government.”

    Other than Pence’s closely watched policy speech, the greatest stir Friday was caused by Prime Minister Justin Trudeau of Canada, who drew flocks of phone-wielding photographers as he worked the pavilion exhibits.

    In an address to governors, Trudeau called US-Canada relations “the most successful economic partnership in the history of the world.”

    Pence’s visit appeared geared toward wooing red-state governors to back the GOP plan, giving political cover to their Senate colleagues.

    After his speech, Pence was scheduled to meet with Nevada’s Republican governor, Brian Sandoval, whose concerns about the health care bill were cited as a reason for the initial skepticism of Nevada’s GOP senator, Dean Heller.

    James Pindell of the Globe staff contributed to this report. Jim O’Sullivan can be reached at