Lisa Murkowski won’t vote to scrap Medicaid expansion if Alaska wants it

Republican Sen. Lisa Murkowski says she will not vote to repeal Obamacare’s expansion of Medicaid so long as state lawmakers in Alaska want to keep it, a bold stance that underscores the challenge before GOP leaders who want to dismantle the 2010 health law and phase out its vast expansion of government insurance for the poor.

Ms. Murkowski also said she does not think Planned Parenthood “has any place in our deliberations on the Affordable Care Act.”

“Taxpayer dollars should not be used to pay for abortions, but I will not vote to deny Alaskans access to the health services that Planned Parenthood provides,” she told the state legislature Wednesday in a prepared address.

As it stands, Republican leaders want to use fast-track rules to gut Obamacare and defund Planned Parenthood as punishment for its abortion practice. Federal dollars don’t actually flow to abortion, anyway, but conservatives say taxpayers should instead be propping up community centers that don’t offer the service.

The repeal-and-defund effort is based on a 2005 bill that used “budget reconciliation” to bypass a Democratic filibuster but ran into President Obama’s veto.

House GOP leaders also want to replace parts of the health care law this time, while phasing out generous federal funding for states, like Alaska, that chose to expand their Medicaid populations.

Ms. Murkowski’s qualms over defunding Planned Parenthood aren’t new — she joined two other centrists in trying to strip the defending provision from the 2015 effort.

Yet it underscores the trouble Senate Republicans who hold just 52 seats could have in tying the Planned Parenthood fight to Obamacare repeal, which is already a thorny issue.

While House conservatives are itching to scrap the health care law and treat all states the same under Medicaid, centrist Senate Republicans who represent expansion states will face pressure to keep generous federal funding that’s covered thousands.

Ms. Murkowski said Obamacare has failed her state and led to “crushing premium hikes” in the individual market, though she acknowledged that Medicaid is a sticking point.

“The discussion that is the elephant in the room is Medicaid expansion. Here in Alaska, some 27,000 Alaskans — 28,000 actually — now have coverage for the first time,” Ms. Murkowski told lawmakers. “Which means they have access to care for the first time. While I clearly have concerns about the expansion’s long-term costs, it has strengthened our Native health system and reduced the number of uninsured that are coming into our emergency rooms. So as long as this legislature wants to keep the expansion, Alaska should have the option — so I will not vote to repeal it.”

Earlier this year, Ms. Murkowski and Sen. Susan Collins, Maine Republican, bucked the GOP and voted against President Trump’s pick for education secretary, Betsy DeVos. Their opposition required Vice President Mike Pence to cast a tie-breaking vote.