GOP Heads Off Major Internal Fight Over Medicaid Expansion … For Now

Republicans pushing for passage of GOP leadership’s Obamacare replacement bill were able to head off a major intra-party fight over how the legislation handled Medicaid expansion — at least for now, as supporters of phasing out expansion even sooner than the current bill withdrew an amendment to that effect Thursday.

Under the leadership’s bill, the American Health Care Act, Medicaid expansion would be allowed to continue until the end of 2019, at which point enrollment would be frozen, with the expectation that the program would wither away on its own. Conservatives are pushing for that deadline to come sooner, and Wednesday, during the mark up of the AHCA in the Energy and Commerce Committee, Rep. Joe Barton (R-TX) introduced an amendment that would have frozen the program at the end of 2017. By Thursday morning, as criticisms of the idea from expansion state Republicans began to rack up, the amendment had been withdrawn and the bill passed by the committee with its expansion provisions as is.

“The challenge is, is you’ve got a diverse set of stakeholders, you’ve got moderate senators, you’ve got conservative folks like me in the House, and then you have the governors, you’ve got to keep them on board,” said Rep. Bill Flores (R-TX), an Energy and Commerce committee member who is supportive of moving forward the year expansion would freeze from 2020 to 2018.

“That would have spooked the governors,” he told TPM, adding that “if we convince the governors it’s OK,” that it could come back later in the process.

Before it was withdrawn, it had earned the endorsement of the Republican Study Committee, a group a of 170-or-so conservative member whose chair Rep. Mark Walker (R-NC) (pictured) has been very critical of the leadership’s legislation. Thursday afternoon Walker said “we’re still trying to get there,” when asked about the fate of expansion amendment and a seperate proposal to impose work requirements on certain Medicaid enrollees that the RSC also endorsed.

According to Axios, Barton said that President Trump’s administration is also “looking at it,” and that he has received “considerable amount of positive feedback” in discussions about it.

The amendment could be introduced again later on in the process, perhaps in the Rules Committee, which will mark up the legislation after it’s passed out of the Budget Committee, or on the House floor, depending on how the bill comes up for a vote.

But adding the provision would risk the objection of Republicans, particularly in the Senate, who represent expansion states.

“I think you’re going backwards,” Sen. Lisa Murkowski (R-AK), whose state expanded Medicaid, told reporters Thursday morning. “When you go backwards I think it makes it more difficult [for the Senate to pass the bill].”

And it even might run into the problems in the House, where the more centrist members — who have largely been out of the spotlight while conservatives revolted against the bill — were also vocally raising concerns.

“Taking this Medicaid window back from 2020 to 2018, that’s going to big problem for those of us in the expansion states,” said Rep. Charlie Dent (R-PA), co-chair of the moderate Tuesday group.

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