Health & Human Services

Trump Backs 2 Medicaid Changes to GOP Health Bill

by | March 20, 2017

By Lisa Mascaro

President Donald Trump privately told House conservatives he was "1,000 percent" behind the GOP's Obamacare repeal as they incorporate new Medicaid changes ahead of next week's vote.

Republicans trying to amass support before the House vote first will amend the bill to draw in more conservatives who said Friday they would vote yes if the changes are made.

Trump met Friday with members of the conservative Republican Study Committee at the White House and endorsed their ideas to change the Medicaid provision by allowing states to take federal funds as a lump-sum block grant and impose a work requirement for patients receiving care.

"He said he was 1,000 percent behind us," said Rep. Bruce Westerman, R-Ark., who was among those attending. He noted that in public remarks to the media afterward, Trump said he was 100 percent behind the bill.

"He really wants to see this pass and wants to see health care improved for the country, and he sees this as a big win."

Rep. Mark Walker, R-S.C., the group's chairman, said they worked with the administration all night on the proposal.

Republicans are trying to build momentum for the bill ahead of a scheduled vote next Thursday.

Another conservative group of House Republicans, the smaller Freedom Caucus, also has pressed for changes, but it is unclear whether their requests are being included. They want to reduce the essential benefits that health insurers must provide in their policies.

While adding conservative elements to the bill may help Speaker Paul Ryan amass the votes for passage, the strategy risks losing more moderate lawmakers who are worried their constituents will be left without health care coverage.

Ryan also may end up passing a legislative package that is dead on arrival in the Senate, where Republicans have largely panned the House effort.

"I have serious concerns and reservations about the bill in its current form," said Rep. Charlie Dent, R-Pa., who does not believe the tax credits, which start at $2,000 for young adults and rise to $4,000 a year for those over 60, are substantial enough to purchase private health insurance.

"We don't like sending a bill over to the Senate that's dead on arrival," he said. "I'd rather have a better sense of where the Senate is before we send it over."

The Medicaid changes have been a long-sought conservative goal and would be a substantial reform of the decades-old health care program that serves the poor, disabled and elderly.

By block-granting the funding, the states would have more flexibility to design their programs free from federal interference.

For example, Westerman, the Arkansas congressman, said he would like to see his state require Medicaid recipients to start paying a premium or co-pay for health care, so patients "have some skin in the game."

Health care advocates, though, have warned that patients may opt to go without health care because they cannot afford the payments or are unable to meet new work requirements.

The nonpartisan Congressional Budget Office said that 24 million more Americans would be uninsured if the House bill became law _ essentially wiping out the coverage gains made under Obamacare.

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