State lawmakers said they don’t know how to prepare the state for an Affordable Care Act replacement, because they don’t know what that could even look like.

In the respective Democratic and Republican leadership press conferences Tuesday, state lawmakers said they were focused on state issues since they don’t know what to expect from Congress when it comes to the ACA.

Congress Republicans have criticized and campaigned against the ACA since its inception, and have called for its repeal since it was signed into law in 2010. Now that the GOP controls Congress, it’s still not clear what the GOP’s comprehensive plan is for replacement.

“Once we see what the fed decides to do, then we will make the adjustments necessary,” said Rep. Dan Kristiansen, R-Snohomish, at the press conference.

State Democrats also said they couldn’t plan for every scenario, but expressed concern about rolling back Medicaid expansion.

“I’d say first and foremost, what we’ve been taking a look at is what is the potential damage to the hundreds of thousands that we’ve enrolled through Medicaid expansion,” said Sen. Sharon Nelson, D-Maury Island at the Democrats’ press conference. “What is going to happen to their health insurance? This is just another element of the uncertainty that has rolled into Washington D.C. and our state has to take a look at.”

Block grants have been floated as a way Congress may reduce Medicaid spending, and is described in this PBS report by Shefali Luthra:

“Currently, states share the cost of Medicaid with the federal government. Poorer states pay less: In Mississippi, for instance, the federal government pays about three-fourths the cost of the program, compared to 50 percent in Massachusetts.

“The federal funding is open-ended, but in return, states must cover certain services and people — for instance, children, pregnant women who meet income criteria and parents with dependent children. Under a block grant, states would have more freedom to decide who qualifies, and for what services,” according to the report.

Sen. Mark Schoesler, R-Ritzville, said “clarity and certainty” will be important moving forward.

“It’s really early in the process to tell my member of Congress what it is exactly I want,” he said at the press conference.

But, he said it would be difficult to roll back Medicaid expansion.

“I think it would be very difficult to go backwards from that,” he said. “If (Congress) gave us a little more flexibility on how the Health Care Authority administers it, that could certainly be useful.”

Nelson said Democrats are planning for “worst case” scenarios (regarding health care and other issues, like legalized marijuana), but can’t plan specifically without a specific federal plan on the table.

“You can’t have a contingency for everything that could happen in Washington D.C.,” said Rep. Pat Sullivan, D-Covington, at the press conference. “But when we pass our budget it’s going to have to make sure that we deal with those impacts.”

Erin Fenner: erin@washingtonstatewire.com, @erinfenner

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