GOP Moves to Limit Medicaid Spending in Obamacare Repeal Measure

Committees in the House of Representatives may begin considering legislation to repeal and replace the Affordable Care Act in early March, and when they do, Rep. Daniel Donovan said he won't vote for the first without the second.

During this morning's speech to a group of governors at the White House, President Donald Trump opined on the state of health care in this country and promised to repeal and replace Obamacare, which he continuously referred to as a "disaster". Their purported calculation is that they can force wavering Republicans to go along with the bill for fear of betraying the noble cause of Obamacare repeal that has animated the base for years. As was the case with House Speaker Paul Ryan's 2016 A Better Way, Medicaid is a dominant theme, and replacement goes far beyond finding an alternative means of covering those added to Medicaid under the ACA's expansion of eligibility. One issue, according to Trump, is that health insurance policy is hard.

Baker, a Republican, has already told congressional leaders that he opposes the idea of the federal government giving MA a lump sum to fund Medicaid, instead of paying about half of the program's costs as it does now.

The House GOP leadership team is growing increasingly concerned by the President's unwillingness to embrace - or many believe, fully understand - the congressional approach to health care.

"Federal changes to Medicaid should protect the states that did not previously expand ObamaCare".

Health consultants Avalere and McKinsey & Co. looked at how plans to switch Medicaid to a block-grant system or a per capita funded program would affect states and enrollment.

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Across the nation, states have reported large premium increases and a shrinking number of insurers willing to take part in the so-called marketplaces to offer individual coverage under Obamacare. Industry lobbying group America's Health Insurance Plans, was also in attendance.

Republicans are still planning to include "replacement" measures in the repeal bill that involve the expansion of Health Savings Accounts, significant changes to Medicaid and tax credits, sources said. The President said that rules made by agencies will be examined to ensure that the rules "make life better for American workers or consumers".

Ohio Gov. John Kasich, who said he disagrees with the drafted bill, has especially cautioned his party about scaling down Medicaid. Mary Mayhew, commissioner for Maine's Department of Health and Human Services, told the Journal, "We would not have been anywhere near as optimistic [previously] as we are with the Trump administration in their desire to provide flexibility to the states".

"Governor Baker has repeatedly conveyed to federal officials that any changes, including block grants, resulting in a reduction of federal support for MA are unacceptable", Lizzy Guyton, a spokeswoman for the governor, said in an e-mail on Monday.

Trump described his meeting with the CEOs as "Great". "We're talking about people's lives".

Other GOP governors, including Rick Scott of Florida, have advocated a full repeal of the law.

  • Megan Austin