Richard Ryman

USA TODAY NETWORK-Wisconsin

GREEN BAY - U.S. Sen. Ron Johnson again is undecided on the Republican health insurance reform package.

Johnson said Friday in Green Bay that a reported comment by Senate Majority Leader Mitch McConnell, R-Ky., that Medicaid reform will probably never happen under the plan, is a "breach of trust."

Johnson did not say he would vote against the bill, but he has moved from strongly favoring a procedural motion to get the bill on the Senate floor for debate to being undecided.

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McConnell needs 50 Republican votes to pass the measure, designed to replace the Affordable Care Act, also known as Obamacare. The Republicans have 52 senators and two, Susan Collins of Maine and Rand Paul of Kentucky, have indicated they will not support the bill. One more no vote and it's dead.

"I am concerned about Leader McConnell's comments to apparently some of my Republican colleagues — 'Don't worry about some of the Medicaid reforms, those are scheduled so far in the future they'll never take effect,'" he said. "I've got to confirm those comments ... I think those comments are going to really put the motion to proceed in jeopardy, whether it's on my part or others."

Johnson, who spoke to about two dozen Greater Green Bay Chamber members and other invited guests, favors Medicaid reform based on giving states more control of the program and ending the Medicaid expansion allowed under Obamacare.

He said good parts about the bill include that it would start to stabilize markets that are collapsing, give management of Medicaid to states, add more free market competition and allow greater use of health savings accounts.

"Many of us, one of the main reasons we are willing to support a bill that doesn't even come close to repealing Obamacare ... was because at least we were devolving the management back to the states, and putting some level of sustainability into an unsustainable entitlement program," he said.

"If our leader is basically saying don't worry about it, we've designed it so that those reforms will never take effect, first of all, that's a pretty significant breach of trust, and why support the bill then?"

Johnson said Medicaid expansion under Obamacare made the program available to able-bodied, childless, working-age adults, which threatens program stability and could have an adverse effect on traditional Medicaid enrollees — the elderly, disabled and children.

Johnson also was critical of the development of the bill, which was largely carried out behind closed doors.

"I kind of had to muscle my way into that core working group," he said. "I was shocked at the process. There was no information. Very little. It was the last step in the process. It doesn't surprise me the result is far from what I'd like to see.

"The goal was 50 votes. How do you pass a bill? (Repealing) Obamacare should have been the goal of our effort. How do you actually fix a health care system?"

Johnson discussed other health care issues as well.

» The senator said Americans have made a decision to cover people with pre-existing conditions and high-cost conditions and make it affordable for them. He favors assigning them to high-risk pools. He said it would cost less and allow better management of their conditions.

» On opioid treatment funding, he said the solution is reducing the demand for drugs. He said dealing with the crisis is a three-legged stool: interrupting supply, interdiction and treatment, and reducing demand by discouraging drug use.

"If you have the demand, you will have the supply. Unfortunately, treatment is incredibly ineffective," he said. "We've been incredibly effective reducing demand for tobacco. We've got to learn the lessons from that."

He said you have to level with young people about the dangers of drug use.

"There's nothing glamorous about ending your life in squalor from an overdose," he said.