Early splits appear as Senate Republicans confront Medicaid choice


Republican senators hailing from states that took ObamaCare’s Medicaid expansion are taking different tacks on defending the program as much of their party looks to end it. 

Sen. Rob Portman (R-Ohio) told reporters Tuesday that he supports rolling back the Medicaid expansion by ending the extra federal money for it, as long as there is a “soft landing.” 

But Sen. Shelley Moore Capito (R-W.Va.) told The Hill that she wants the expansion of coverage to remain, though she said it did not have to be in the same form. 

ObamaCare provided extra federal money to states allowing them to expand eligibility for their Medicaid programs, which help poor and disabled residents, with the federal government paying 90 percent of the costs. Accepting the expansion became optional after the Supreme Court ruled that states could not be forced to take it.

The Medicaid expansion has provided health insurance to about 11 million people, and what to do about it is one of the thorniest questions facing the Senate as it begins work on its ObamaCare repeal plan.

Portman said he supported ending the extra federal funding for the program eventually and that a new tax credit in the Senate bill, as well as money in a “stabilization fund,” could help people currently in the Medicaid expansion get private coverage. 

Asked if the extra federal funds would go away, Portman said: “Yes, but there would also be a stabilization fund, there would also be funding for a tax credit that’s not available currently, and I’d like to change the House version of the tax credit, by the way, focus it more on people who are close to the poverty line.”

The House bill would end the federal funds for the Medicaid expansion after 2020. Portman said that date could be pushed back. “I think there ought to be a soft landing,” he said. 

Capito, though, took a more forceful stance in defense of keeping Medicaid expansion. 

“I am seriously interested in reforms to Medicaid and better ways to make the money go further, but I’ve seen a lot of benefits to the Medicaid expansion in our state, particularly in the mental health and opioid and drug abuse areas,” Capito said. 

Asked if that meant she wants to keep Medicaid expansion, Capito said, “Well, yeah, I mean, we need to make sure these folks have access permanently either under this or some other kind of way.” 

“We can’t just drop them off and wish em good luck,” she added. 

Republicans senators from states that have expanded Medicaid have been meeting to discuss the issue. Portman said about eight of them met before a meeting of the Senate’s healthcare working group on Tuesday. 

But if senators from states that have expanded Medicaid are split, it could diminish the ability of any lawmaker to try to preserve the program. 

Conservatives are pushing to phase out the program as quickly as possible. 

Rep. Mark Meadows (R-N.C.), the chairman of the conservative Freedom Caucus, has said he has spoken with Sen. Steve Daines (R-Mont.) on a plan to phase out the Medicaid expansion, perhaps over a longer period than is called for in the House bill. 

Sen. Lisa Murkowski (R-Alaska), whose state also expanded the government insurance program, declined to elaborate on her views. 

“I’ve got to figure out a way to make sure that the fine people of Alaska who have seen the benefits of Medicaid expansion don’t have the rug pulled out from underneath them,” she said. “End of comment.”

Tags Lisa Murkowski Rob Portman Shelley Moore Capito
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