Axios

The Associated Press has gotten a draft of the Medicaid reform plan Republican governors want to propose to the Trump administration and Congress. You might want to sit down for this one: they want more flexibility to manage their costs, but they also want the federal government to keep paying for most of the program.

It's become pretty obvious that Obamacare repeal isn't moving ahead — with no committee action scheduled yet for next week — and now we're getting a better idea why.

The Washington Post posted a piece this morning about how House Republicans want to steer away from Obamacare's expansion of Medicaid without hurting the states. Most of the details — keeping some money flowing to the expansion states, helping the non-expansion states with extra payments for the poor and uninsured — have been floated before. But the bigger news starts in the 11th paragraph: The Congressional Budget Office says the new, age-based tax credits, another part of the replacement plan, "would cost the government a lot of money and would enable relatively few additional Americans to get insurance."

Between the lines: This tracks with what we've heard unofficially through other sources, and suggests that Republicans are having trouble designing their plan in a way that would get acceptable cost estimates. That doesn't mean they can't tinker with the plan until they get better CBO estimates — Democrats did a lot of that during the writing of Obamacare. But it does mean the plan probably won't be ready quickly enough to meet the Republicans' ambitious timeline.

It's looking like a big health care meetings day for President Trump on Monday. First, he's bringing the governors to the White House in the morning, on the last day of their National Governors Association meeting in Washington — and health care is sure to be a big topic, especially the future of Medicaid. Then, Bloomberg reports, he's going to have a talk with top health insurance executives, including the head of the Blue Cross and Blue Shield Association. Anthem and Cigna officials also have been invited.

Between the lines: The meetings suggest that Trump is getting more involved in some of the biggest Obamacare repeal problems the Republicans have to solve — like how to end the law's Medicaid expansion without hurting the states, and how to keep insurers in the market during the transition to a new system.

Details of the GOP's new healthcare plan are beginning to emerge, as pieced together by Bloomberg:

• Right to choose whether to purchase health insurance or not, which means not everyone will be covered.
• Like Obamacare, the GOP plan will provide tax credits to help people purchase insurance, but those subsidies will be based on age rather than income — meaning poorer people won't get additional money.
• Threat of rolling back Medicaid: About 12 million people currently have coverage through Medicaid expansion.
• Insurers would be allowed to charge more to anyone — whether they are healthy or have a pre-existing medical condition — who had a gap in their health insurance coverage.
• Timing: Trump said Wednesday that there will be a White House health plan by sometime in March.

Why it matters: The story shows Republicans acknowledging what most health care analysts already suspected: The replacement won't cover as many people as Obamacare, partly because the GOP isn't really trying to compete on that level.