As Republican lawmakers have vowed to introduce new legislation in the coming weeks there still at least two main iusses to be worked out:  the future of Medicaid- the government health insurance program for the poor that was expanded in more than 30 states under Obamacare-  and how a new healthcare law would be funded.

One emerging scenario could be that the roughly 11 million Americans who have gained Medicaid coverage will be would be “grandfathered in,”  but the GOP would block that enhanced funding for any new participants.

States that did not expand Medicaid could receive more money through increased federal “disproportionate share” payments used to help hospitals that serve a large number of uninsured patients.

The House committee also is moving forward with a plan to convert the rest of Medicaid to a system in which states would get a fixed sum of federal money for every resident who is enrolled.

The idea is that Medicaid funding would be capped on a per capita basis. This is better than the “block grant” approach that Republicans had been considering, because the latter would allot a fixed total sum to states that would end up resulting in cuts over time as health care costs escalate.

The Politico journal has pubblished a copy the proposal, however house staffers would not comment on the authenticity of the document, which was dated Feb. 10. 

However even if the document could be an old version, it might be an indication of the general direction Republicans are taking.

 Nicholas Bagley, a University of Michigan law professor and health policy expert tries to sum up the draft”: “The emerging GOP replacement would repeal tax hikes on the very rich and, instead, impose a tax that would hit many more people, including lots of public employees like schoolteachers and police officers. At the same time, it would slash Medicaid for the poorest Americans, as well as subsidies that the near-poor rely on to buy private coverage.”

U.S. health insurance executives, many of whom have lost hundreds of millions of dollars on the Obamacare individual insurance markets, are due to meet with Trump on Monday, according to a Bloomberg report.

Source: The Washington Post, Politico, Bloomberg