An influential bloc of House conservatives backed two proposed changes to the Obamacare replacement plan Thursday, saying it could soften their general opposition to the broader GOP proposal.
The Republican Study Committee, which boasts roughly 170 members, wants to freeze Medicaid enrollment under Obamacare’s generous funding rates at the end of this year, rather than letting states herd more people into expanded programs until 2020.
“Not for three more years, but for this year — one more year,” said Rep. Joe Barton, Texas Republican who proposed the amendment in the Energy and Commerce Committee, where a markup of GOP proposals eclipsed the 24-hour mark Thursday.
The RSC also endorsed a proposal by Rep. Morgan Griffith, Virginia Republican, to institute work requirements for able-bodied, childless adults on Medicaid.
“While I continue to have concerns about this bill, the adoption of these amendments would be a critical step in the right direction,” group Chairman Mark Walker, North Carolina Republican, said of the Medicaid changes.
The proposals will be resisted by Democrats who are holding up debate in the Energy and Commerce Committee with a series of amendments aimed at poking holes in the GOP’s plan to dismantle the Affordable Care Act.
The Ways and Means Committee finished its work on tax-related portions of the replacement plan overnight, but the commerce markup stretched into a second day, with no clear end in sight.
While Democrats have rejected the plan outright, conservatives say they could get to “yes” with major changes.
They say the plan creates a new entitlement by offering refundable tax credits to people who buy insurance on their own and simply replaces Obamacare’s “individual mandate” with a fee imposed by insurers, while allowing Obamacare’s Medicaid expansion to linger.
Tightening up the Medicaid portion of the bill would appease some conservatives, though it could alienate centrist Republicans in expansion states that have benefitted from the influx of federal funding, creating a thorny path forward for GOP leaders whipping votes for their plan.
Ohio Gov. John Kasich, a Republican, says the Medicaid expansion helped his state care for the mentally ill and beat back opioid addiction.
The Supreme Court in 2012 said states could choose not to expand their Medicaid programs to those making up to 138 percent of the federal poverty level, as Obamacare envisioned, without forfeiting existing federal funds for the program, which is run jointly with states.
Thirty-one states, plus D.C., expanded, while the rest resisted, citing their opposition to Obamacare or fears their state budgets would explode when federal funding for the newly eligible population slid from 100 percent to 90 percent by 2020.
The GOP plan tries to put holdout states on more equal footing with expansion states by restoring certain hospital payments, which were cut under Obamacare, in 2018, for states that didn’t expand.
Expansion states must wait until 2020 for those slashed payments to be restored.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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