Four GOP senators pledge to vote against rolling back Medicaid expansion

Four GOP senators pledge to vote against rolling back Medicaid expansion
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Four GOP senators on Monday told Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellLawmakers feel pressure on guns Bipartisan group of House lawmakers urge action on Export-Import Bank nominees Curbelo Dem rival lashes out over immigration failure MORE (R-Ky.) they will vote against any ObamaCare repeal bill that eliminates the healthcare law's Medicaid expansion. 

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"We believe Medicaid needs to be reformed, but reform should not come at the cost of disruption in access to health care for our country’s most vulnerable and sickest individuals," the senators said in a letter to McConnell. 

"Any changes made to how Medicaid is financed through the state and federal governments should be coupled with significant new flexibility so they can efficiently and effectively manage their Medicaid programs to best meet their own needs."

The senators said a "gradual transition" is needed to ensure states have the time to implement changes. 

They noted that a Feb. 10 draft of the repeal bill "does not meet the test of stability" for people currently enrolled in the program. 

"We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states," the letter reads. 

Some of the Senate's most conservative members, however, have argued the expansion must be repealed because it is too costly. 

How to deal with Medicaid is a major obstacle for Republicans as they look to repeal ObamaCare. 

GOP senators want to repeal the healthcare law through reconciliation, a procedure that only needs 50 votes to pass. Republicans have a 52-seat majority in the Senate, meaning they can only afford to lose two votes from their party. 

The Feb. 10 draft would eliminate ObamaCare's Medicaid expansion in 2020. States could still cover those people, but would not get the extra federal funding to do so. 

The draft would also cap Medicaid payments to states based on the number of enrollees. 

Leadership is expected to unveil its repeal plan sometime this week.