By Kerry Young, CQ Roll Call
December 13, 2016 -- Republican members of the Senate Finance Committee on Tuesday invited GOP governors to provide feedback on future changes to Medicaid, which consumes a sizable chunk of state budgets nationwide. The lawmakers are readying for a planned partial repeal of the 2010 health law that allowed states to expand eligibility for the state-federal health program.
Senate Finance Republicans addressed their letter to members of the Republican Governors Association, a group that largely opposed the Medicaid expansion of the 2010 law. Still, many Republican governors did expand the program and even in those that didn't, there's been a significant increase in the Medicaid rolls in many states with GOP senators.
Sen. Patrick J. Toomey, R-Pa., is among the signers of the Finance letter to Republican governors. After the health care law was enacted, about 548,000 more people signed up for Medicaid in Pennsylvania, according to the Kaiser Family Foundation. A GOP governor had expanded the program.
"We are acutely aware that in dismantling the ACA we have a responsibility for ensuring that Medicaid continues to provide quality of care for our nation's most vulnerable citizens," the Senate Finance Republicans said in their letter. "In addition, we recognize that we have the opportunity to reflect on flexibilities that states have gained in recent years as well as the factors that inhibit states from pursuing innovations and responding to the unique needs of their Medicaid beneficiaries."
President-elect Donald Trump has selected as his nominee for chief of the Centers for Medicare and Medicaid Services (CMS) a consultant who helped negotiated an expansion deal for Indiana's GOP leaders. Seema Verma is expected to be more open to alternative ideas that leaders in other states will present for their Medicaid programs. More than 220,000 people in Indiana became eligible for Medicaid under the expansion, according to Kaiser's figures.
Federal lawmakers and Medicaid officials will face budget woes if they seek to allow Medicaid programs that expand coverage, said Thomas Scully, a former CMS administrator, at the American Bar Association's Washington health law summit. Even before the ACA expansion, significant federal money previously supported state efforts to test new approaches to expanding health coverage through Medicaid, Scully said. Given GOP lawmakers' campaign calls for restraining federal spending, states are unlikely to receive much further help of this kind, he said. That will lead to jockeying for available funds, which Scully described as "a massive state-by-state formula fight."