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 McConnellTrump stays out of Arizona's ugly and costly GOP fight Sen. Warner to introduce amendment limiting Trump’s ability to revoke security clearances The Hill's 12:30 Report MORE (R-Ky.) they will vote against any ObamaCare repeal bill that eliminates the healthcare law's Medicaid expansion. 

Sens. Rob PortmanRobert (Rob) Jones PortmanSenate panel spars with Trump administration over treatment of unaccompanied immigrant children Senate study: Trump hasn’t provided adequate support to detained migrant children Senators introduce bill to change process to levy national security tariffs MORE (Ohio,) Shelley Moore CapitoShelley Wellons Moore CapitoSenate GOP battles for leverage with House on spending Lawmakers, media team up for charity tennis event The Hill's Morning Report — Trump picks new fight with law enforcement, intelligence community MORE (W.Va.), Cory GardnerCory Scott GardnerBusinesses fear blowback from Russia sanctions bill Senate GOP campaign arm asking Trump to endorse McSally in Arizona: report When it comes to drone tech, wildfire officials need the rights tools for the job MORE (Colo.) and Lisa MurkowskiLisa Ann MurkowskiThe Hill's Morning Report: Dems have a majority in the Senate (this week) Senate gets to work in August — but many don’t show up Trump nominee won't say if he supports funding agency he was selected to run MORE (Alaska), all from expansion states, said they want to ensure those covered won't be left in the cold. 

"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.