Republicans consider unraveling a key part of Obamacare in Trump agenda bill

The chair of the House committee overseeing health care policy said they're looking at unwinding the federal promise to cover 90% of the 2010 law's Medicaid expansion.

WASHINGTON — Top Republicans are considering rolling back a major piece of the Affordable Care Act in their massive bill for President Donald Trump's agenda, exploring savings by slashing how much money the federal government spends to cover the 2010 law's expansion of Medicaid.

Rep. Brett Guthrie, R-Ky., the chair of the House Energy and Commerce Committee, made the case for it Monday as Congress returned from a two-week recess, saying Medicaid spending is growing at an unsustainable rate.

“We have an expansion population that gets 90% federal money, and you have traditional [Medicaid], so a disabled child in Kentucky gets 72 cents when they go to the doctor. And we know that’s just unsustainable,” Guthrie said. “We want to fix that so everybody gets coverage. So I think it’s going to be a really responsible response.”

Guthrie’s committee is tasked with finding $880 billion in savings, a target that can't be met without cutting Medicaid or Medicare, according to Congress' nonpartisan budget scorekeeper.

The menu of options includes changes to Medicaid’s Federal Medical Assistance Percentage (or FMAP) and a new per capita cap on the population of people covered under the expansion. While Guthrie didn’t confirm what will make it into the package, he said he’d like to finalize it and vote it out of committee next week.