Averting deep Medicaid cuts key as Senators draft own health bill

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Sen. Susan Collins (R-ME) is holding meetings with a bipartisan group of Senators.
Sen. Susan Collins (R-ME) is holding meetings with a bipartisan group of Senators.

Senate Republicans headed into the long Memorial Day weekend determined to make progress on a bill to replace Obamacare, but some notable players were guarded, if not outright skeptical, that much could be accomplished soon.

One possibility is a two-step process that would postpone a repeal of the Affordable Care Act (“Obamacare”) until 2020 in order to keep the insurance markets relatively stable in the short term, key players have said.

A major stumbling block is what to do about Medicaid, which is far and away the top payer of nursing home services in the U.S. A House-passed bill would eliminate $800 billion in planned Medicaid funding over a decade, something numerous Senators on both sides of the aisle have said they could not abide by.

Enhanced tax credits for poor seniors are likely to make a GOP Senate bill, but wide disagreement remained about how to scale back Medicaid expansion that has taken place under the ACA and deal with the program's affordability.

Nursing home leaders have roundly criticized the House bill and President Trump's budget proposal because of their calls for Medicaid payment reductions.

A group of more than a dozen Republican Senators was expected to intensify private talks over the holiday weekend about possible bill provisions. At the same time, Sen. Susan Collins (R-ME) has held discussions with a bipartisan group of about a dozen Senate members to explore more centrist positions. Democrats in both the House and Senate have unanimously withheld support from the House bill.

"Over the break, initial legislation will be drafted and then we'll have more time, actually have a basis to discuss" specific policies, Sen. Ron Johnson (R-WI) told Bloomberg BNA late last week after meeting with the Senate Republicans' healthcare working group. "We've had the discussions. It's time to draft a bill, and we'll move forward on that when we get back."