Major Cuts To Medicaid Expected To Stay In Revised Senate O’Care Bill

The tweaks that GOP leadership is making to its stalled Obamacare repeal legislation will not likely include a major rollback of its cuts to Medicaid, a top Republican told reporters Tuesday.

“What we had in the original bill has not changed with regard to Medicaid,” Sen. John Barrasso (R-WY) (pictured above), a member of the Senate GOP leadership team, said after a conference lunch where the revised bill was outlined in broad strokes. The text is set to be released on Thursday, with hopes for a new CBO score on Monday.

Axios also reported that the Medicaid provisions were likely to stay without major changes.

The original legislation, the Better Care Reconciliation Act, begins phasing out the Affordable Care Act’s expanded Medicaid program in 2021, with the enhanced match rate drawn down entirely by 2024. It also transforms the overall program into a so-called “per capita cap,” which limits the funding states will get from the feds on a per enrollee basis (as opposed to the current unlimited match rates.) The limit rises over time at slower rate than Medicaid’s traditional spending growth, with an even more draconian inflation metric introduced in 2025.

Overall, the CBO estimated that these cuts would result in 15 million fewer insured by 2026 compared to current law, and greater coverage losses in the decade after that.

Keeping the original Medicaid provisions will put in a bind the senators who cited the Medicaid cuts as a reason they could not support that version of the legislation. At least three Senate Republicans have said publicly the cuts would need to be softened to earn their support. If they stick to that the position, the bill will not have the 50 votes it needs to pass.