Republican senators wrestle with changes to Medicaid

Republican senators wrestle with changes to Medicaid

Republican senators who hail from states that expanded Medicaid are meeting about the future of the program as their party moves ahead with the repeal of ObamaCare.

The senators had their first meeting on Wednesday in the office of Sen. Rob PortmanRobert (Rob) Jones PortmanSenate investigation finds multiple federal agencies left sensitive data vulnerable to cyberattacks for past decade Senate panel advances bill to protect government devices against cyber threats House passes bill to establish DHS cyber 'first responder' teams MORE (R-Ohio), who is from a state that expanded Medicaid and whose Republican governor, John Kasich, has been a vocal defender of it. 

Asked if the senators were trying to preserve the expansion of Medicaid, Portman told The Hill: “We're trying to get a sense of where everybody is right now; we're not decided on anything.”

“We found out, not surprisingly, there are different points of view among senators who are from states that have expanded Medicaid,” he added. 

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Figuring out what to do with ObamaCare’s expansion of Medicaid, the government healthcare program focusing on low-income people, is one of the thorniest questions for Republicans as they look to repeal the law. 

The expansion has provided coverage for about 11 million people in 31 states that accepted the expansion of eligibility. Some of those states have Republican governors who are wary of losing the federal money that came with expansion and having their constituents possibly lose coverage. 

Conservatives, though, including the leaders of the House Freedom Caucus, are pushing to simply use the same ObamaCare repeal bill that Congress passed in 2015, which included repeal of the Medicaid expansion. 

Finding some sort of resolution to the Medicaid question is a tough task for Republicans and a crucial step to being able to get the votes to pass a repeal bill. 

Republicans from states that did not expand the program also don’t want to be treated in an unequal way under a replacement and lose out on funding.  

Portman said one thing the senators agreed on Wednesday is to try to use money from “whatever net savings there are from repeal” toward trying to help people get coverage “to help on transition.”

He also said the senators agreed on granting states more flexibility, pointing to a waiver to make changes to the rules of the Medicaid program in Ohio that was rejected by the Obama administration. 

Some Republican senators have said they would like to keep the Medicaid expansion. Asked if she wanted to keep the expansion, Sen. Shelley Moore CapitoShelley Wellons Moore CapitoPress beat lawmakers to keep trophy in annual softball game Bipartisan senators propose forcing EPA to set drinking water standard for 'forever chemicals' August recess under threat as yearly spending bills pile up MORE (R-W.Va.), said Tuesday, “Yeah absolutely.” 

“I want to keep those people in the system, covered in some way,” she added. “That's something I’m looking over watchfully. It's very important to me.”

Another question on Medicaid is whether federal payments to states will be capped in some way, known as block grants or per capita caps, something that Republicans have long proposed and that Democrats say would lead to harmful cuts to benefits.  

The path forward right now on Medicaid is not clear. 

At a meeting of Republican governors and lawmakers in Washington last month, Kasich floated a compromise idea of bringing down the eligibility level for the expansion to 100 percent of the federal poverty line, from the current 138 percent. 

“We're meeting, Republican senators who have states that expanded Medicaid, talking about what's the right transition to get through this repeal and replace,” said Sen. Steve Daines (R-Mont.). “So we're coming together and looking at different options, something of a transition plan, to be determined in more detail.”