Pence tells US governors it's time for 'end of Obamacare'

Providence: Vice President Mike Pence told a bipartisan gathering of governors on Friday that he and President Donald Trump believe the revised health care bill before the US Senate is the "right bill at the right time to begin the end of Obamacare."

"The president said he wanted a health care system that in his words is far less expensive and far better," the Republican vice president said during a conference of the National Governors Association. "We believe the Senate health care bill begins to make the president's vision a reality."

Pence urged governors to support the plan, which was written by Republicans and would make major changes to the signature domestic policy of former President Barack Obama, a Democrat.

"I want to challenge each one of you to work together with this administration, to give the American people access to the world-class health care they deserve," he said.

But several governors, Democratic and Republican, expressed concern about the bill and even outright opposition. Montana Gov. Steve Bullock, a Democrat, said Republicans in Congress are "still trying to put lipstick on a pig. But guess what: It's still a pig."

Major cuts to Medicaid, the state-federal insurance program for the poor, the disabled and nursing home residents, is a key sticking point for many governors, especially those in states that expanded it under Obama's health care law.

Canadian Prime Minister Justin Trudeau followed Pence in addressing the governors from about 30 states. Trudeau, when asked about the debate over health care in the US compared to Canada's national health care system, said he doesn't think it's appropriate for one country to lecture another on how it should govern itself.

He focused his speech on the fundamental importance of the relationship between the US and Canada and how he'd like to see "a thinner border for trade, not a thicker one." He told the governors that barriers to trade between the countries kill growth and don't help working families.

Trudeau said the North American Free Trade Agreement should be modernized," as it has been in the past, and he's confident its renegotiation will be done to the benefit of all countries.

Pence also spoke about modernizing NAFTA so it's a "win, win, win" for all the trading partners. Pence and Trudeau met to talk about trade on the sidelines of the meeting.

Pence, after his address, met with several governors, including Republicans Brian Sandoval, of Nevada, and Asa Hutchinson, of Arkansas.

Sandoval had characterized his reaction to the latest Republican health care bill as one of "great concern" immediately after it was released Thursday.

Hutchinson was more receptive, but both said they worried about Congress shifting costs to the states to maintain the same level of Medicaid coverage they have committed to.

Nevada and Arkansas are among the 31 states that expanded Medicaid under the Obama-era law, adding coverage for roughly 11 million Americans.

Sandoval said Pence had some very positive things to say about the effort to make the bill better. He praised funding that was added to help states confront the opioid epidemic but said he remains concerned about making sure the 210,000 Nevada residents who gained coverage through the Medicaid expansion don't lose that coverage.

Meanwhile, several Democratic governors met Friday to publicly criticize the revised health care bill and talk about how unwinding the Medicaid expansion created by the Affordable Care Act would hurt their states.

Democratic Rhode Island Gov. Gina Raimondo said she planned to voice strong opposition to Pence. "There's a high degree of anxiety," she said. "Even Republican governors will say that they're worried, especially the ones that have taken the Medicaid expansion."

Senate Majority leader Mitch McConnell plans to keep in place Medicaid cuts that Republican governors and Senate moderates have objected to. No Democrats support the plan.

The latest changes are geared toward increasing access to bare-bones private insurance. There's also an additional $45 billion to help states confronting the opioid epidemic.

North Carolina Gov. Roy Cooper, a Democrat, called that funding a "fig leaf." Many of the "flimsy" policies that will be allowed under the legislation wouldn't cover substance abuse treatment, he said.

A governors-only session on Saturday will give them a chance to ask questions of US Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma.