Lawler. Photo: Michael M. Santiago / Getty Images
A moderate House Republican on Tuesday pushed back strongly on Medicaid changes floated by a key House chair, highlighting the rocky road ahead for GOP consensus on how much to cut the program in reconciliation.
Why it matters: Reducing federal funding for Medicaid expansion enrollees puts moderates in a politically difficult spot, though not all are pushing back as Rep. Mike Lawler is.
What they're saying: Asked by Axios if he was open to lowering the 90% share of federal costs, known as the FMAP, Lawler replied: "I've been very clear about this. You guys keep asking the same stupid f--king question: No."
- "I've said from the very beginning: I'm against per capita caps, I'm against changing the FMAP floor," he added.
- Asked to clarify that he is opposed to lowering "any and all FMAP," meaning the 90% expansion FMAP, not just the FMAP for traditional Medicaid, Lawler replied, "Yeah, period."
Between the lines: We reported Monday that House Energy and Commerce Chair Brett Guthrie said the House GOP is considering a per capita cap for Medicaid expansion enrollees.
- Guthrie has also long backed lowering the 90% expansion FMAP.
- Lawler's comments put him at odds with both those ideas, with extremely tight margins in the House.
Yes, but: Some moderates are leaving more room for funding cuts than Lawler is.
- Asked about lowering the FMAP for the expansion, Rep. Don Bacon said Tuesday that he needed to study the issue more. "I'm willing to consider and debate," he said.
- Rep. Jeff Van Drew, asked about per capita caps, said he is open to "guardrails" on the growth of Medicaid and that he would have to "think about" lowering the 90% expansion FMAP. He stressed that he does oppose lowering the 50% FMAP floor for traditional Medicaid.
- Senate Republicans have potentially even greater concerns with Medicaid cuts.
The big picture: The array of views highlights the difficulty Republicans have in settling on a reconciliation plan to generate savings for extending tax cuts.
- There is not much time before a planned May 7 Energy and Commerce markup of the committee's portion of the package.
- The committee's GOP members, who met for hours behind closed doors Monday night, were relatively tight-lipped upon leaving the room and said no Medicaid decisions had been made.
- "We're still having discussions on FMAP and per capita allotments," Guthrie told reporters Tuesday morning. "Those are the biggest discussions right now."
- He acknowledged that lowering the FMAP would be "difficult" and said he does not know "if there's 218 votes for that or not, but it's not off the table."
