Republicans eyeing Medicaid overhaul as part of ACA repeal bill

Major reforms to the Medicaid program are on the table this week as Republican lawmakers craft a reconciliation bill that would repeal the Affordable Care Act.

Moving the program to a per-capita cap or block grant system are two of the options currently being considered, according to Rep. Brett Guthrie (R-KY). He noted that there aren't specific details on the potential changes available yet, but that lawmakers are aiming “to deal with Medicaid reform in reconciliation,” Morning Consult reported.

"We're looking at both opportunities to do it through per capita allotment and maybe an optional block grant for states that choose to do so," Guthrie said.

House Republicans are also looking to include a repeal of Medicaid expansion in the reconciliation bill, throwing back to Speaker Paul Ryan's (R-WI) A Better Way plan which included a call for per capita caps as well as expansion repeals. Some lawmakers, particularly those from states that have already expanded the program, are wary of how attempts to roll back the expansions could play out.

“I believe that the Medicaid expansion, that cat is out of the bag. I don't know if that one's getting back in the bag,” said Rep. Charlie Dent (R-PA), according to Morning Consult.

Cuts to Medicaid may first require boosting funding for the program in order to “keep the peace between Republican governors who expanded healthcare for low-income people under Obamacare and those who resisted,” Politico reported on Wednesday.