Source: Senate leaders to offer $200 billion to win over moderates

Source: Senate leaders to offer $200 billion to win over moderates
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In a bold move to revive their healthcare bill, Senate Republican leaders are getting ready to propose giving $200 billion in assistance to states that expanded Medicaid, according to a person familiar with internal Senate negotiations.

The huge sum would be funded by leaving in place ObamaCare’s net investment income tax and its Medicare surtax on wealthy earners, according to the source briefed on the proposal.

The figure is likely to outrage conservatives, who would prefer to use the savings from the Senate healthcare bill to pay down the deficit.

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The source said the aid would be targeted primarily at Medicaid expansion states, adding it would be distributed on “the back end” of the bill’s timeline, when the legislation would phase out the generous federal contribution for expanded Medicaid enrollment — a central pillar of ObamaCare.

The goal is winning the support of wavering moderate Republicans who will make or break the legislation: Sens. Rob PortmanRobert (Rob) Jones PortmanSenators look for possible way to end shutdown GOP reasserts NATO support after report on Trump’s wavering Leaders nix recess with no shutdown deal in sight MORE (R-Ohio), Lisa MurkowskiLisa Ann MurkowskiSenators look for possible way to end shutdown Leaders nix recess with no shutdown deal in sight McConnell: Senate will not recess if government still shutdown MORE (R-Alaska), Shelley Moore CapitoShelley Wellons Moore CapitoOvernight Energy: Wheeler weathers climate criticism at confirmation hearing | Dems want Interior to stop drilling work during shutdown | 2018 was hottest year for oceans Dems blast EPA nominee at confirmation hearing Republican senators skeptical of using national emergency for wall funding MORE (R-W.Va.) and Dean HellerDean Arthur HellerTrump’s shifting Cabinet to introduce new faces Trump's most memorable insults and nicknames of 2018 Progressive strategist says changing demographics will help Dems MORE (R-Nev.). 

A spokesman for Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellOcasio-Cortez rips Trump in first House floor speech: 'It is not normal to shut down the government when we don’t get what we want' Overnight Health Care: Dem chair plans hearing on Medicare for all | Senate GOP talks drug prices with Trump health chief | PhRMA CEO hopeful Trump reverses course on controversial pricing proposal Supporters leave notes on plaque outside Ocasio-Cortez's office MORE (R-Ky.) declined to confirm or deny the pending offer, as has been the leader’s practice of not commenting on negotiations.

President Trump promised senators at a White House meeting Wednesday that he is prepared to spend tens of billions of dollars more to address their concerns but spoke in only general terms.

“The president said today we’re prepared to put money at things,” said a senator from a Medicaid-expansion state who attended the lunch.

The $200 billion proposal, however, was not discussed at a meeting hosted Wednesday evening by Sen. John BarrassoJohn Anthony BarrassoOvernight Energy: Wheeler weathers climate criticism at confirmation hearing | Dems want Interior to stop drilling work during shutdown | 2018 was hottest year for oceans Dems blast EPA nominee at confirmation hearing Dem senator expresses concern over acting EPA chief's 'speedy promotion' MORE (Wyo.), the Republican Policy Committee chairman, according to a lawmaker who participated. 

The windfall for Medicaid expansion states would come on top of a proposal that Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, made to moderate GOP senators at a lunch meeting at the White House on Wednesday.

Verma told nervous senators from Medicaid expansion states that the administration would be willing to give states flexibility to use Medicaid funds to subsidize the healthcare costs of people not enrolled in the entitlement program.

The so-called Medicaid wraparound would give states a way to help low-income people who don’t qualify for traditional Medicaid if they end expanded enrollment because of a reduction in federal funding.

The wraparound would allow states to draw from Medicaid to subsidize the costs of low-income people with high premiums and deductibles. 

That money would come in addition to $132 billion the revised bill already sets aside for a long-term state innovation fund and $45 billion to treat opioid addiction.

Low-income people could also use refundable tax credits to pay for insurance premiums under the revised Senate proposal.

But moderates were not initially sold on Verma’s Medicaid proposal, in part because it raises the question of whether it would stretch the program too thin since the bill also includes hundreds of billions in cuts. 

“I think it’s best to sum it up as: it’s complicated. It will have differing impacts depending on where each state is respectively,” Murkowski said after Wednesday’s meeting.

Plowing an extra $200 billion in federal assistance to Medicaid expansion states could shore up any funding shortfall in case traditional Medicaid funding, the long-term innovation fund and the tax credits prove inadequate.