Senate GOP considers deeper Medicaid cuts than House bill

A leading option in the Senate's ObamaCare repeal-and-replace debate is to make even deeper cuts to Medicaid spending than the bill passed by the House, according to lobbyists and aides.

The proposal would start out the growth rate for a new cap on Medicaid spending at the same levels as the House bill, but then drop to a lower growth rate that would cut spending more, known as CPI-U, starting in 2025, the sources said.

That proposal has been sent to the Congressional Budget Office (CBO) for analysis, a Senate GOP aide said.

The aide said that plan has been described as a "consensus option that has been sent to CBO," though no final decision has been made yet. Another aide said there are still other options in the mix.

Democrats and some more moderate Republicans were already warning about Medicaid cuts in the House-passed bill, which reduces Medicaid spending by more than $800 billion over 10 years.

The CBO found that the House bill would cause 14 million fewer people to be enrolled in Medicaid over 10 years.

More moderate Republican senators could object to the proposal. 

Asked about the plan, Kevin Smith, a spokesman for Sen. Rob PortmanRobert (Rob) Jones PortmanSens introduce bipartisan bill matching Zinke proposed maintenance backlog fix On The Money: Trump backs off investment restrictions on China | McConnell opens door to tariff legislation | Supreme Court deals blow to public-sector unions, ruling against 'fair-share' fees McConnell opens door to tariff legislation MORE (R-Ohio), said: “Rob does not support a growth rate that is lower than the House bill.” 

And Sen. Dean HellerDean Arthur HellerSenate GOP PAC books millions in red state ad spending Left mounts heavy pressure campaign on swing senators over Supreme Court Senate passes mammoth farm bill MORE (R-Nev.) said earlier this month that he did not want the growth rate to be any lower than the House bill's. Heller is considered the most vulnerable GOP senator on the ballot in 2018.

More conservative senators, however, have been pushing for the lower growth rate as part of an effort to restrain Medicaid spending further.

A separate Medicaid issue — how quickly to phase out the funding for the expansion of the program — remains up in the air. Moderates have pushed for a seven-year phase-out, while leadership has floated three years.

—Updated at 10:56 a.m.