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Senate GOP leaders are working on a last-ditch effort to alleviate concerns from several Republicans about the potential impacts to their states from the Medicaid provisions in their sweeping domestic policy bill.
Senate Majority Leader John Thune, R-S.D., told NBC News yesterday that they are “working on a solution for rural hospitals,” adding, “I think we’re making good headway on that solution.”
A draft proposal from the Senate Finance Committee, the panel that has jurisdiction over Medicaid, would create a $15 billion fund for rural hospitals and providers, according to two sources with direct knowledge of the proposal. This would drive up the overall cost of the bill if it’s included.
But multiple Republicans — including Sens. Thom Tillis of North Carolina, Josh Hawley of Missouri and Susan Collins of Maine — said the $15 billion figure falls short of what is needed.
The American Hospital Association, a lobbying group representing the industry, warned this month that the House-passed legislation “would result in a $50.4 billion reduction in federal Medicaid spending on rural hospitals over 10 years.”
As part of the broader legislation for Trump’s agenda, Republicans are limiting the health care provider fee that states, with the help of the federal government, use to fund Medicaid, particularly in rural areas. According to Republicans, this fits within their targeting of “waste, fraud and abuse” in Medicaid, because they say the tax is abused by blue states to provide benefits to undocumented immigrants.
But the reality for dozens of rural areas across the country is that these Medicaid changes would lead to billions in funding losses, and the consequences could be devastating, as Tillis pointed out in a document he shared with his colleagues.
Sen. Bill Cassidy, R-La., said the fund “is a good way to start” alleviating his concerns about the Medicaid provisions his party is negotiating. Still, Cassidy said he is “leaning towards supporting” the bill even if the fund won’t be large enough to fix the issue.
