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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 McConnellGOP leaders hesitant to challenge Trump on Saudi Arabia Overnight Health Care — Presented by Purdue Pharma — Trump officials ratchet up fight over drug pricing | McConnell says Republicans could try again on ObamaCare repeal | Dems go on offense against GOP lawsuit Republicans should prepare for Nancy Pelosi to wield the gavel MORE (R-Ky.) they will vote against any ObamaCare repeal bill that eliminates the healthcare law's Medicaid expansion. 

Sens. Rob PortmanRobert (Rob) Jones PortmanElection Countdown: O'Rourke brings in massive M haul | Deal on judges lets senators return to the trail | Hurricane puts Florida candidates in the spotlight | Adelson spending big to save GOP in midterms How Kavanaugh got the votes  Collins to support Kavanaugh, securing enough votes for confirmation MORE (Ohio,) Shelley Moore CapitoShelley Wellons Moore CapitoThe Hill's Morning Report — Presented by PhRMA — Dem path to a Senate majority narrows GOP shrugs off dire study warning of global warming Overnight Health Care — Presented by the Coalition for Affordable Prescription Drugs — Senators face Wednesday vote on Trump health plans rule | Trump officials plan downtime for ObamaCare website | Lawmakers push for action on reducing maternal deaths MORE (W.Va.), Cory GardnerCory Scott GardnerDemocrats must end mob rule GOP senators praise Haley as 'powerful' and 'unafraid' Democrats won’t let Kavanaugh debate die MORE (Colo.) and Lisa MurkowskiLisa Ann MurkowskiEx-Florida lawmaker leaves Republican Party Murkowski not worried about a Palin challenge Flake on Kavanaugh confirmation: To see GOP 'spiking the ball in the end zone' doesn't seem right 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.