The House Energy and Commerce Committee now has a firm deadline to resolve intraparty skirmishing over Medicaid, with what's shaping up to be a marathon markup set to begin on Tuesday afternoon, Peter and Victoria report.
Why it matters: Lawmakers said Thursday they still have not come to a final agreement on the Medicaid policies to be included in reconciliation, leaving just a few days to whittle down options for cutting the safety net program.
Driving the news: One idea that's under discussion, sources say, is to require some Medicaid enrollees to pay increased "cost-sharing" for their care.
- For example, enrollees with income above the federal poverty line could have to pay a higher share. Medicaid currently has very limited cost-sharing because of the low incomes of enrollees.
- "I think we have to find cost savings in there, and you have to stop the abuse of emergency departments and hospitals," Rep. Nick Langworthy, an Energy and Commerce member, told Axios Thursday when asked about the idea.
- "I think some level of ... cost-share, everyone else has to do that in their private insurance. If it's a negligible fee, that is something that should be explored."
- That idea would open Republicans to criticism about increased health costs for poor patients, though.
Energy and Commerce Chair Brett Guthrie also didn't rule out limiting provider taxes that help finance the non-federal share of Medicaid spending, though he noted that policy is "a little more difficult," when asked on Wednesday.
- It also appears that per capita caps are still being discussed, though moderate GOP lawmakers have expressed concerns about the policy, and Speaker Mike Johnson has cast doubt on its inclusion.
- "There's a lot of opposition to per capita caps," Langworthy said, while noting the situation is in flux. "And there's still a question whether the president supports per capita caps."
- With some of these contentious Medicaid policies appearing less likely to be included in the final reconciliation package, it's not at all clear how the committee is going to find $880 billion in savings that the GOP budget resolution calls for.
The intrigue: Energy and Commerce Republicans spokesperson Matt VanHyfte confirmed that the committee is planning to hold its markup next Tuesday starting at 2 p.m. ET.
- There's been talk that the markup could run through the night and last more than 24 hours.
- During the 2017 ACA repeal-replace fight, a key reconciliation markup lasted for 27 hours, and it's possible that members want to beat that time record.
- HHS Secretary Robert F. Kennedy Jr. will also be testifying in front of the Senate HELP Committee next Wednesday afternoon, creating the prospect of a split-screen moment if the House markup runs long.
- House Ways and Means is also reportedly holding its reconciliation markup next Tuesday at 2 p.m.
