President Donald Trump’s administration is just days old, but New Jersey Democrats are already sounding alarms about what some of his initial moves could mean for the state budget.

It’s unsurprising that a Democratic legislative majority in the state where defeated Democratic candidate Hillary Clinton got her eighth-highest share of the vote would be battling the new Republican president.

But Democrats say their worries are no longer just hypothetical. Trump’s first executive order, issued Friday, directed his administration to find ways to step back from the Affordable Care Act. And Trump’s counselor, Kellyanne Conway, told NBC he would propose turning Medicaid into a block-grant program.

Democratic lawmakers say the repeal could reduce federal aid to New Jersey by $3 billion and add $1 billion in spending to the state budget, leading to cuts in the program if the fixed-amount block grant doesn’t provide the same funding as the open-ended Medicaid program.

“The new president, I think his advisers like to say, ‘Well, give it to the states. They are closest to the people.’ And that is true,” said Senate Majority Leader Loretta Weinberg, D-Bergen. “And we would be happy to take it as long as all the money comes with it, so that we can afford the good health care that is being provided to our citizens right now.”

Sen. Joseph Vitale, D-Middlesex, the Senate health committee chairman, conceded that it’s too soon to know what Trump will propose. But he said the block-grant approach would be harmful.

“New Jersey, here is your money, and good luck with that. Cover those you want to cover, don’t cover those you can’t,” Vitale said. “hey’re really framing this as giving the states independence, which is really code for ‘We really don’t care what happens to your people because we’re going to give you a defined bucket of money.’

“It’s not independence. It doesn’t give us any real flexibility,” Vitale said. “We will have to get tighter and smarter but also crueler if it is that we have to cut enrollees from the program, because the state of New Jersey frankly can’t afford to pick hundreds of millions of dollars in taxpayer costs to continue to fund the program.”

Vitale said 568,000 in New Jersey have Medicaid coverage because of the program’s expansion under the ACA, which is also known – often derisively – as Obamacare. Right now, the federal government is paying for 90 percent of the costs under the expansion, rather than the typical even split.

“What if they decide to make it 80/20? Or 70/30? Or 60/40? Or 50/50 again? How are we going to make up the difference? We just frankly can’t do that,” Vitale said.

Senate Majority Leader Loretta Weinberg speaks at a news conference about President Donald Trump's health-care agenda. (Michael Symons/Townsquare Media NJ)
Senate Majority Leader Loretta Weinberg speaks at a news conference about President Donald Trump's health-care agenda. (Michael Symons/Townsquare Media NJ)

Vitale said Gov. Chris Christie, an ally of Trump, has “got to use all the influence he can” convincing officials in Washington not to reverse the Medicaid expansion.

Other Republican governors have voiced concerns about rolling back the Medicaid expansion, such as Massachusetts Gov. Charlie Baker and Ohio Gov. John Kasich.

Senate President Stephen Sweeney, D-Gloucester, said he doesn’t expect Christie to oppose most of Trump’s agenda but noted Christie opted for the Medicaid expansion, at a time some other Republican governors did not.

“Gov. Christie has a phone number,” Sweeney said. “Gov. Christie showed true leadership when he supported the expansion and has talked on how good it has been for the state of New Jersey, and it really has been. So now we’re going to be calling on him and other legislators united to make sure that Congress doesn’t do a horrible, horrible thing by taking away health care for 20 million people.”

Christie’s office declined to respond to the Democrats’ push.

Sen. Paul Sarlo, D-Bergen, noted the state has been able to reduce its charity-care aid to hospitals by $350 million because more people are insured.

“Make the minor modifications. Make the minor tweaks that maybe are necessary. But a repeal of the Affordable Care Act would have a devastating impact on the state of New Jersey’s budget,” Sarlo said.

“Just take pension payment, school funding, property tax,” Sarlo saisd. “With the uncertainty with what’s going to happen with Medicaid expansion, the repeal of the Affordable Care Act, the impact on charity care, those other three big priorities of all ours and many of you in this room and the state, right now puts all them into a very uncertain place.”

“How are we going to deal with property taxes if we lose a billion, billion and a half dollars?” Sweeney said. “What aid do you think gets cut?”

Sweeney said there’s a lot of uncertainty around many issues, with health care at the forefront.

“Look, I’m excited about President Trump’s expansion of transportation. I’m trying to have a positive look as he’s coming into office,” Sweeney said. “But so far, the things and the actions he’s taken are scary as hell.”

New Jersey: Decoded cuts through the cruft and gets to what matters in New Jersey news and politics. Follow on Facebook and Twitter.

Michael Symons is State House bureau chief for New Jersey 101.5 and the editor of New Jersey: Decoded. Follow @NJDecoded on Twitter and Facebook. Contact him at

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