A group of House conservatives is calling for significant “structural reforms” of Medicaid as part of the Republican reconciliation legislation, illustrating the seemingly intractable differences across GOP factions.

In a “Dear Colleague” letter led by Rep. Chip Roy (R-Texas) and signed by 19 others, the lawmakers said the GOP conference must pursue “meaningful reforms” in reconciliation, including eliminating the enhanced federal matching funds for states that expanded Medicaid.

“Congress should ensure the FMAP [federal medical assistance percentage] for able-bodied adults matches everyone else,”........

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