TRENTON — Six months ago, Republican Gov. Chris Christie called a press conference touting the benefits of his decision to expand the Medicaid program when Obamacare went live in 2014.
With an additional 566,000 people insured, paid for by the federal government, Christie said he had “proven wrong the naysayers” and did that what was best for New Jersey.
But with President Donald Trump and congressional Republicans promising to repeal the Affordable Care, Christie on Monday made it sound like his commitment to Medicaid was negotiable.
And that’s making a growing number of New Jersey medical professionals, lawmakers and family advocacy groups nervous for the people who could be squeezed out of coverage.
“I don’t necessarily think they need to have Medicaid, but they need to have coverage,” Christie said during his monthly 101.5 FM radio call-in show Monday night.
“I don’t know what the President and Congress are going to come up with to deal with at all that,” Christie said, adding he would “take the president at his word” that people would not be stranded without coverage.
The governor and Trump confidante reiterated his support for an idea floated by Congressional Republicans that would allot each state a set amount of money known as a “block grant,” but give state lawmakers more freedom to decide how it is spent.
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Medicaid is now an open-ended entitlement program, which pays for at least half of all billable care if states follow federal strict regulations.
Christie said his chief concern is that Trump and Congress set the dollar amount of the block grant based on what New Jersey receives now with 566,000 more people on Medicaid, and not the pre-Obamacare amount.
New Jersey receives a $4.4 billion boost under the landmark health care law to expand the Medicaid program to poor people with slightly higher incomes.
“For New Jersey, you want a block grant based on the expanded Medicaid so we could manage it the right way. I bet you we could get some savings, and that savings could be shared with the federal government,” Christie said.
Reactions to Christie’s remarks range from disappointment to surprise.
“It is very disappointing that the governor has made it clear that unlike other governors he will not support maintaining the Medicaid expansion,” said Raymond Castro, senior analyst at New Jersey Policy Perspective, a left-leaning research organization.
“It’s surprising he made that statement given that he also said he did not know what they are going to replace the Medicaid expansion with,” Castro added. “All indications are that they will replace it with something much worse, such as a Medicaid block grant, that not only will not help working New Jerseyans but will threaten the healthcare of seniors, the disabled and children as well.”
Some of Christie’s key legacy-building items rely on a robust Medicaid program. He announced last month he would fund 900 drug treatment beds to halt the heroin and opioid addiction crisis.
Early in his first term, the governor also received permission from the Obama administration to spend more federal money on adding community housing and other programs for people with developmental disabilities.
“Most proponents of block grants see them as a way to reduce federal spending on Medicaid over time,” said Joel Cantor, director of the Rutgers Center for State Health Policy. “The grants almost certainly would not go up as fast as the cost of medical care.”
“During recessions block grants won’t automatically increase, but people will lose their jobs and employer health insurance and many will seek Medicaid coverage,” Cantor added.
Thomas Baffuto, executive director of The Arc of New Jersey, an advocacy organization for people with developmental disabilities and their families, said he is marshaling the energy of the Arc’s members to fight the Obamacare “repeal without a reasonable replacement.”
The Christie administration’s “Medicaid waiver” program brings $800 million from Medicaid into New Jersey, which pays for group homes, job and recreational programs for roughly 25,000 people.
“It’s had an incredible impact on their quality of life,” Baffuto said.
That’s why block grants are not reasonable solution, Baffuto said.
“Ultimately they will lead to cuts, and the best case scenario is long waiting lists. Worst: people lose services and we are deeply concerned about all of that.”
The New Jersey Hospital Association has also appealed to state and federal lawmakers to find a way to protect Medicaid. New Jersey hospitals and outpatient medical facilities forfeited $1.5 billion in federal aid with the promise that the Affordable Care Act would bring in more patients.
“So many of the strides we’ve made in expanding access to health care — and in reforming our health care system for the future — are now in danger of being walked back,” said Betsy Ryan, the association’s president and chief executive officer.
If Christie is worried, he is not letting on. During his January radio program, he said: “I think the president understands that block grants are not about program reduction.”
“I don’t think there is anybody who is saying we should not be spending money — a significant amount of money — on the opioid crisis. I am not concerned about that,” the governor added.
Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.
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