Illustration: Annelise Capossela / Axios
Senators left a key meeting on reconciliation Monday night without a clear plan for addressing concerns about strict limits on the Medicaid provider tax that states use to help fund their share of program costs.
Why it matters: Overcoming some GOP senators' concerns about the tighter cap in the Senate bill and how that can lead to deeper Medicaid cuts is essential to any hopes of passing the bill this week.
Driving the news: GOP leaders mentioned the idea of a fund to help rural hospitals deal with the fallout from lower provider taxes and program cuts, but did not elaborate, Sen. Josh Hawley said afterward.
- "They said the word 'fund,'" Hawley said. "And then when people said, 'Well, what would it be structured like?' They said, 'Well, we don't know. We're working on it.'"
- Sen. Susan Collins, on her way into the meeting, said she was still opposed to the Senate bill's provider tax limits and floated a provider relief fund of as much as $100 billion.
The bottom line: Majority Leader John Thune told senators in the meeting that the chamber's reconciliation bill would not lower the federal matching share, or FMAP, an idea that had resurfaced in recent days but was disputed by some lawmakers, according to Hawley.
- Hawley also warned that the bill could not pass the House without a solution to the provider tax concerns.
Sixteen House moderates wrote a letter Tuesday opposing the Senate's deeper cuts to provider taxes and state-directed payments. It called for reverting to the House language.
- "I do not want to go to a conference committee," Hawley said. "I do not want this thing to lag for another month."
