Illustration: Gabriella Turrisi/Axios
House Energy and Commerce Republican leaders are circulating a menu of options for overhauling Medicaid to members and staff with a week to go before a planned reconciliation markup, per multiple lobbyists who've received the list.
Why it matters: The list enumerates more than one dozen ways Republicans could use changes to the safety net program to generate savings in reconciliation.
What's inside: The options on a list that lobbyists received from Hill staff, and Axios reviewed, include:
- Normalizing the expansion population FMAP under 90 — a reference to lowering the 90% share of federal costs for the Medicaid expansion population.
- Minimum cost-share for expansion population.
- Lowering the FMAP floor.
- A 10% FMAP reduction for expansion population for states that cover undocumented immigrants.
- Prohibition of coverage for undocumented immigrants
- Rescinding a temporary FMAP increase from the American Rescue Plan.
- Normalize the District of Columbia's FMAP.
- Per capita caps.
- Provider tax reduction
- Managed care organization tax.
- Medicaid eligibility reporting requirements.
- Rescinding Biden-era nursing home staffing rule.
- Retroactive coverage.
- Prohibition on transgender care for minors.
- Prohibition on transgender care for all beneficiaries.
Yes, but: Sources cautioned that this may not be a comprehensive list, but only some of the main items up for discussion. The process remains fluid because no final policy decisions have been made.
- House Energy and Commerce communications director Matt VanHyfte told Axios that he couldn't comment on "speculated policy options that may or may not be in the final bill text."
- "In all actuality, we are still going through a large menu of options and everything is on the table."
