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The leading Medicaid plan in the Senate

Jacquelyn Martin / AP

The Senate's current leading option for how to revise Medicaid is to phase out the Affordable Care Act's expansion more slowly than the House did, but grow a per-person funding cap at the same rate as the House bill, according to two GOP aides.

This isn't a final plan, but it is the recommendation Majority Leader Mitch McConnell made to Senate Republicans on Tuesday. One of the aides said members are still fighting over the growth rate. Conservatives have been calling for a lower rate, and moderates want an even longer glidepath away from the expansion than the one being proposed.

More details:

  • Medicaid expansion: The House bill would immediately reduce enhanced federal spending for Medicaid expansion in 2020, except for people who were already enrolled in the program. New enrollees would receive the state's traditional match rate, which is much lower than the enhanced one under the ACA.The Senate proposal would create instead a three-year glidepath beginning in 2020 down to the lower matching rate to give states more time to adjust to the reduced funding.This was Sen. Rob Portman's idea, although he is pushing for a seven-year transition period.
  • Per-person cap: This would grow over time at the same rate as the House bill, which was tied to medical inflation. Conservative Republicans want the growth rate to be lower than that.