House Republicans are pushing toward a vote next week on their bill to repeal Obamacare and replace it with their own programs, even as holdouts resist pressure from House Speaker Paul Ryan and President Donald Trump to give the proposal enough support to pass.
That's one reason any changes to federal Medicaid funding will face widespread opposition.
They wrote the current GOP proposal's approach to Medicaid "provides nearly no new flexibility for states, does not ensure the resources necessary to make sure no one is left out, and shifts significant new costs to states". Ileana Ros-Lehtinen of Miami - say the original bill cuts off too many people and they won't vote for it.
I envision a true marketplace for health care that empowers Montanans with more control over their spending, lowers the cost of care, and offers countless options for quality coverage that meets personal needs and budgets. Republicans need to lower the high costs of insurance premiums, she said, with moves like allowing insurance to be sold across state lines and negotiating lower prescription drug prices. And Texas has more uninsured residents than any other state.
Impoverished seniors who can not afford nursing care are also major Medicaid recipients.
Trump met at the White House on Friday with 13 members of the House Republican Study Committee, a large group of conservative lawmakers seeking changes to Medicaid, the joint federal-state health insurance program for the poor. It's called a per-capita cap, and the payments under that formula would start in 2020, but would be based on how much the state spends this year.
"In Louisiana, cuts of this magnitude would negatively impact services to the most vulnerable covered by Medicaid, including the elderly, disabled, children and pregnant women", the organizations said in a joint statement. Under the GOP plan, the cost would explode to $14,600 - more than half of that person's total income. These populations make up 96 percent of people on Medicaid in Texas. Outlaw it altogether. If medical providers didn't have insurance companies to write them big checks, then they would be forced to cut costs.
The question is: Am I OK losing my election because I did the thing I promised I would do? said Freedom Caucus co-founder Labrador, referring to his promise to repeal the entire law. We are looking in all the wrong places. "It's a bad deal for the American people".
"They're not always right", Rep. Todd Rokita (R-IN) said in an interview with FOX59 on Monday.
It would also eliminate the ACA requirement that states cover basic mental health and addiction treatments if those states expanded Medicaid under the bill.
Representative Charlie Dent, a Republican moderate, said the House bill should be crafted to win support in the Senate, where numerous Republicans have voiced skepticism.
"It's going to be a huge rush - an inducement to drag in as many people as they can drag in, because the more they can drag in, the more federal dollars they can get", he says. Finally, the new bill would prevent "non-expansion states from expanding Medicaid during the expansion phaseout", according to Axios.
This story is part of a reporting partnership with NPR, KUT and Kaiser Health News.