By Raymond Castro

With this week's late-night Senate vote, lawmakers in D.C. have begun their attempt to repeal the Affordable Care Act and Medicaid expansion. As the prospects of repeal have become more realistic, some courageous Republican governors are pressing Congress to protect the health coverage of millions of their constituents.

Time's running out, and Gov. Chris Christie should join them now to make the urgent case to Congress and President-elect Trump to protect the most certain piece of his legacy: expanding Medicaid for over half a million low-income New Jerseyans.

In the State of the State address, Christie emphasized the critical role that the Medicaid expansion played in the state's efforts to treat New Jerseyans addicted to opioid drugs. Over three-quarters of the funding for the governor's major behavioral-health and substance-use disorder initiative this year was from federal Medicaid dollars. It is that very guarantee of federal matching funds for an unforeseen health crisis that Republicans in Congress want to eliminate. Yet while the governor spent the bulk of his State of the State on what he sees as the urgent need to fight addiction, he has thus far remained silent about protecting his best vehicle to fund that fight. That needs to change.

As a Republican with close ties to the Republican Party and the President-elect, Christie is in an excellent position to advocate for 530,000 struggling New Jerseyans who are at risk of losing the only health insurance if the Medicaid expansion is repealed. At the very least, the governor should tell New Jersey's Republican Congressmen that it would be the height of irresponsibility to repeal Obamacare without replacing it at the same time.

In addition to preserving health care for hundreds of thousands of New Jerseyans, Christie has a lot riding on this issue because his decision to opt for the Medicaid expansion could arguably be considered his most important legacy as governor. The benefits to New Jersey have been stunning and unprecedented. Over a half million low-income, mostly working, residents have obtained health coverage, the primary explanation for the historic one-third decrease in the state's uninsurance rate. His decision has generated over $3 billion annually in federal funds for health care, which has helped create thousands of good jobs; and it has saved the state about $700 million each year, helping to balance the state budget.

The governor - one of 16 Republican governors who expanded Medicaid - is aware of the benefits to New Jersey, and in the past has enthusiastically defended his decision. Now, with the threat to health care access rising to new heights, it is time for him to do so again. By doing so, he'd be joining some of his fellow Republican governors from around the country, like Doug Ducey from Arizona, Ohio's John Kasich and Rick Snyder from Michigan, who have already pressed Congress to spare their programs from repeal.

Christie's case would be especially compelling because losing the Medicaid expansion would cause much greater harm to New Jersey than most other states. New Jersey saw the ninth largest increase in Medicaid enrollment in the nation due to the expansion. Taking away health coverage from hundreds of thousands of New Jerseyans could create a health care crisis of historic proportions, while a loss of up to $3 billion loss in federal funds would also wreak havoc in the state's health care industry and its fragile budget and economy.

These are arguments that New Jersey's Republican Representatives should listen to - especially if they are made by a fellow home-state Republican. In addition, they know the tremendous harm that such a loss in health care would mean in their districts. In fact, 145,000 New Jerseyans who are now covered under the Medicaid expansion live in their districts.

Christie also should urge New Jersey's Congressional delegation to not repeal the ACA without first replacing it with something better. This goes far beyond the Medicaid expansion and includes the fate of the health insurance market, consumer protections and even Medicare improvements. A recent poll found that three in four Americans either do not want the ACA repealed or repealed without a replacement at the same time.

But that is not what the Republicans in Congress are planning; they want to repeal now, and then figure out how best to replace later. Since Congressional Republicans haven't been able to agree on a replacement for the last six years, even though they have voted to repeal the ACA over 60 times, a healthy dose of skepticism regarding their interest in, or capacity to, enact a replacement is warranted.

And the proposals they have discussed - like more tax breaks for the wealthy, high deductibles for bare- bone plans, and reducing essential insurance benefits - would all be bad news for struggling New Jerseyans only making matters worse. The most damaging idea is a Medicaid block grant, which would permanently cap funding at a sharply reduced level. Medicaid is the major health safety net for 1.8 million New Jerseyans. This plan would not only threaten the working poor in the Medicaid expansion, it could result in devastating cuts to health care for seniors, people with disabilities and children for generations to come.

In his final year in office, Christie has a chance to do what's right and clearly beneficial for New Jersey. Will he seek to protect essential health care for struggling residents of his home state, or will he sit on the sidelines while his party destroys a lifeline for millions of Americans?

Raymond Castro is a senior policy analyst at New Jersey Policy Perspective.

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