#

With the American Health Care Act moving to the U.S. Senate, some New Hampshire Republicans are cheering as the bill makes its way through the legislative process. Yet, for some Trump supporters in the Granite State, especially in the North Country, they might not be too happy with its current version.

Despite still having some concerns about the AHCA, Gov. Chris Sununu said on Thursday that he was glad the bill passed the Republican-led U.S. House of Representatives.

“Failure to reform our health care system is not an option,” he said. “It is critical that we keep this conversation moving forward. My concerns with the AHCA remain firm and I expect that the United States Senate will take those concerns into consideration as they work to improve our nation’s health care system.”

Before the House passed the bill on Thursday afternoon, Sununu and 15 other governors sent a letter to House Speaker Paul Ryan reiterating their support for the Obamacare replacement and asked for states to have more flexibility when it comes to Medicaid.

It’s a similar letter Sununu signed on to earlier this year when the U.S. House tried to repeal and replace the Affordable Care Act the first time. In a Friday interview with the Concord Monitor, he applauded the passage of AHCA, but said he still had issues with the current version.

“I love the idea that Congress is taking action, the president is taking action,” he said. “They’re listening to the American people and they’re moving the ball forward. In it’s current form, I still have a lot of concerns, there’s no doubt. But we are moving it forward, and more important than anything is the need to reform the health care system right now that has failed the American people.”

It’s a different tone than he had in March, when he said the first version of the bill didn’t give states flexibility and would hurt New Hampshire’s expanded Medicaid program, which had bipartisan support.

“The bill that’s been proposed in Congress gives us concerns on a lot of different levels, to be very blunt about it,” Sununu said at a March press conference. “What I’m seeing in Washington gives me a lot of pause for concern to be sure, not just on the Medicaid expansion front, because that would drastically affect New Hampshire, but just on the mandates that are coming out of it.”

As expected, all of New Hampshire’s Democratic congressional delegation is opposed to the GOP-led plan. U.S. Reps. Carol Shea-Porter and Annie Kuster voted against the bill. Critics slammed the bill for potentially making millions lose health care and making it harder for people with some pre-existing conditions to find affordable insurance.

Some Granite State health care providers say more than 100,000 low-income New Hampshire residents could be at risk of losing health coverage under the AHCA plan. New Hampshire Hospital Association President Steve Ahnen said his organization was “deeply disappointed” that the U.S. House passed the health care bill.

“This bill is a significant step backwards on the commitment to ensure coverage and we cannot support it,” he said. “We will continue to work with Congress as this bill moves over to the Senate to ensure that any final legislation to repeal and replace the Affordable Care Act improves our health care system in a thoughtful and responsible way, rather than dismantling coverage for our most vulnerable residents.”

President Donald Trump campaigned aggressively on repealing Obamacare and lowering premiums. However, according to recent analysis, it appears premiums would significantly increase for older Granite Staters.

The Henry J. Kaiser Family Foundation, a nonprofit focused on health care, compared premium costs under the ACA and AHCA. For New Hampshire residents aged 60 or older who make $30,000, they could see their premium costs increase by 173 percent under AHCA. However, the same analysis also says younger residents in New Hampshire would pay less under the AHCA plan.

Many critics point out that the Trump-approved health care bill would negatively impact the people who voted for him. This holds up when using Coos County as an example.

Coos County overwhelmingly voted for Trump over Democrat Hillary Clinton by 52 to 43 percent, respectively. There is a large number of residents who are aged 65 and older in the North Country and the average household income is about $42,000, according to U.S. Census Bureau data. Those residents could fare worse under the AHCA plan than under the ACA.

In a Granite State Poll released Monday by the University of New Hampshire Survey Center, Trump’s approval rating in the state has remained steady at 43 percent. It’s the same rating he had in February. Republicans also still overwhelming approve of the president at 83 percent. Survey results from the North Country showed a statistically insignificant change.

It will be interesting to see over the next few months if residents in the North Country, especially those who voted for Trump, change their support. Nationally, it seems his base is sticking with him so far. Now, the U.S. Senate will now take over the AHCA bill and reports suggest the chamber will overhaul the legislation, making it different from the House version. The health care debate in Washington is far from over, leaving how it will ultimately impact New Hampshire a mystery for now.

Follow Kyle on Twitter.

Sign up for NH Journal’s must-read morning political newsletter.

The flurry of activity in the Granite State this week has some calling it the start of the 2020 New Hampshire primary. Former Democratic presidential candidate Martin O’Malley held some meet-and-greets and a town hall meeting on Sunday, and former Vice President Joe Biden is headlining the state Democratic Party’s fundraising dinner on April 30. Smack dab in the middle of the two Democrats is Republican Gov. John Kasich, who visited the state on Thursday to promote his new book.

It felt like a reunion of sorts for Kasich, his team, and over 200 supporters who came to hear him speak at the New Hampshire Institute of Politics at Saint Anselm College. In a small gathering before his speech, he thanked key allies for their help during the 2016 Republican presidential primary. Even though Kasich was in the state in August to campaign for Gov. Chris Sununu in his gubernatorial bid, it’s his first foray back to New Hampshire since Trump won the White House.

Of course, there was an elephant in the room (and not just because the room was chock full of Republicans): is Kasich going to run for president again in 2020? Those waiting with bated breath will have to wait a bit longer.

“People ask why I am back,” Kasich said. “I am back to sell books.”

His new book, “Two Paths: America Divided or United,” came out on Tuesday and one of his first stops in his book tour was New Hampshire, so it’s easy to see where the 2020 speculation comes from.

He mostly talked about his 2016 campaign and national politics, with some advice to his followers who are unhappy with President Donald Trump.

“In course of running for president, something happened to me that never happened before,” he said. “I was, like, so boring, you know, and boring didn’t cut it.”

Kasich finished second in last year’s first-in-the-nation presidential primary, far behind Trump (35 percent to 16 percent). Yet, Kasich spent more time in the state than any other candidate, holding more than 100 town halls during the primary.

He took note of Trump not following through on some of his campaign promises, like ripping up the Iran nuclear deal and deporting “13 million Muslims out of the country.”

“You notice all that promise? It’s all been taken back,” he said.

Ohio Gov. John Kasich speaks at the New Hampshire Institute of Politics at Saint Anselm College to promote his new book, “Two Paths: America United or Divided” on Thursday, April 27, 2017. (Photo Credit: John Kasich Facebook page)

He also encouraged unity, bemoaning the wide political divide in the United States.

“We all ought to spend about 10 minutes a day reading something we don’t agree with. All of us are absorbing only that that we agree with and getting rid of those things that we don’t agree with,” Kasich said. “Over time, I think things are going to settle down and people are going to realize that the difficulties that we face cannot be solved without unity. Difficulties cannot be solved unless we have deliberate and steady solutions to the problem.”

Out of the three “potential candidates” visiting New Hampshire this week, Kasich is probably getting asked the most if he is going to run again in 2020.

“He hasn’t been president for 100 days, yet,” Kasich told reporters. “I mean, everybody needs to take a deep breath. We’ll see how it runs out. He’s the president. Give him a chance. We’ll see how it goes.”

Why is he getting the question more? Well, it’s good political theatre. If there’s still #NeverTrump sentiment in a few years, Kasich is a good person they can rally behind, since he’s one of the few 2016 Republican presidential candidates who did not endorse Trump after he secured the party’s nomination.

That’s not to say O’Malley and Biden aren’t getting asked (both of whom have also skirted the question). The 2020 Democratic primary should be an exciting one, with 20 or so candidates expected to enter the race, but political pundits and the media love the idea of an incumbent president getting a primary challenger.

Challenges to White House incumbents aren’t as rare as people think. Five of the six presidents who served between 1968 and 1992 faced insurrections. When they do — like Ronald Reagan’s challenge of Gerald Ford in 1976, Ted Kennedy’s race against Jimmy Carter in 1980, and Pat Buchanan’s bid to unseat George H.W. Bush in 1992 — it’s usually because they were viewed as unsuccessful or unpopular, especially within their party’s base.

It’s very possible that Trump’s base could leave him in the next three years, but after his first 100 days in office, it appears they are still with him.

A University of Virginia Center for Politics poll of Trump voters released Thursday shows his approval rating at 93 percent with his base.

The most recent poll in New Hampshire shows that a majority of Republicans approve of the president, although not as high as the national average. About 80 percent of New Hampshire Republicans approve of the job Trump is doing as president, according to a University of New Hampshire Survey Center poll from February.

Those percentages would need to decrease for anyone to seriously consider mounting a GOP primary challenge. What does this mean for Kasich? It looks like he’s playing the “sitting-and-waiting game.” If the opportunity presents itself, don’t be surprised to see him be one of the first Republicans to declare their candidacy. For now, he told NH1 News that he will “see how things develop in the future.”

Kasich is still popular in the Granite State, and he said he had a feeling he would return often because he has many friends here, so he could become a regular face in these parts over the next three years.

Follow Kyle on Twitter.

Sign up for NH Journal’s must-read morning political newsletter.