When Advocating, Don't Forget About Your Governor

Medicaid is a joint federal-state program. States design and administer their Medicaid program within broad federal rules and the federal government guarantees matching funds to states for qualifying Medicaid expenditures. As a result of this shared financing structure, Medicaid acts as both a cost to states and the largest source of federal revenue in state budgets. As Congress considers legislation that would overhaul how Medicaid is structured and financed (both traditional Medicaid and Medicaid expansion), input from Governors will hold significant weight. Making the case for health centers to your governor is crucial and can influence both state and federal policy conversations.

What are Governors saying about “repeal and replace” of the ACA?

There have been mixed reactions to the House Republicans’ “repeal and replace” bill across states, even among Republican governors (who represent 33 states). Senators don’t often like to go against their own state’s governor, especially when they come from the same party. It’s likely that Senators will be listening closely to what their state’s governor would like to see and not see in the legislation as it moves along. Republican governors are likely to have significant feedback as it’s been reported they are working on a proposal that they intend to share with congressional members. Early drafts leaked to vox.com last month showed they were still in very different places from one another when it came to the Medicaid expansion program and details of proposed structural changes like a per-capita cap. However, these documents were leaked prior to legislation being officially introduced.

How can I include my Governor in my advocacy efforts?

Consider taking the following steps:

  • Connect with your State Primary Care Association (PCA) – PCAs serve as the state-level policy expert and advocacy lead for health centers. Find the PCA in your state.
  • Invite State and Local Officials to Take Action – Work with your state and local elected officials to demonstrate support for your health center by collecting letters of support that can be sent to your Governor and Members of Congress. Make sure to coordinate with your PCA to collect and present the letters.

If you have questions about recent activities in the states, please contact your state PCA or NACHC’s State Affairs team at state@nachc.org

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