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House GOP not synced on Medicaid plans

One of the thorniest issues facing House Republicans has yet to be resolved, even as the Energy and Commerce Committee barrels toward a meeting early next week to mark up its portion of President Trump’s domestic policy bill.

© The Hill, Greg Nash

As lawmakers left Washington Thursday for the weekend, there seemed to be no consensus on whether a contentious proposal to cap Medicaid spending for the expansion population will be included to help the committee find $880 billion to cut from programs under its jurisdiction.

Reaching that number without entertaining controversial Medicaid cuts would be incredibly difficult.

Committee chairman Brett Guthrie indicated Thursday there are still ongoing discussions about the inclusion of “per capita caps,” a nod to the unresolved tensions between moderates warning against Medicaid benefit cuts and conservatives who want to deeply slash the program’s spending.

The markup, which is expected to start Tuesday afternoon, could go for many hours as Democrats try to make it as painful as possible for Republicans. The committee held a marathon 27-hour markup to debate the GOP ObamaCare repeal legislation in 2017; this one could be even longer.

The markup, which is expected to start Tuesday afternoon, could go for many hours as Democrats try to make it as painful as possible for Republicans. The committee held a marathon 27-hour markup to debate the GOP ObamaCare repeal legislation in 2017; this one could be even longer.

Earlier in the week, Speaker Mike Johnson (R-La.) seemed to have ruled out the inclusion of per capita caps, which made moderates happy and incensed conservatives. But on Thursday, Johnson said the policy was still on the table.

“There's still ongoing discussion about per capita caps, but it's a sensitive thing,” Johnson told reporters, before nodding to the idea that many Republicans don’t think people who gained coverage through ObamaCare’s Medicaid expansion should be covered.

Johnson reiterated that Republicans don’t want to make changes that result in people losing coverage — but a Congressional Budget Office analysis Wednesday showed at least 1.5 million people would become uninsured under a per capita cap policy.

Republicans do have general agreement on other Medicaid changes such as instituting federal work requirements; removing undocumented immigrants from eligibility; and letting states make eligibility checks more frequently.

Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel, Joseph Choi and Alejandra O'Connell-Domenech — every week we follow the latest moves on how Washington impacts your health.

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