Florida Sen. Rick Scott (R) and several Republican allies have unveiled an amendment to President Trump’s “big, beautiful bill” that would reduce Medicaid spending by another $313 billion by limiting the expansion of Medicaid under the 2010 Affordable Care Act, also known as ObamaCare.
The amendment would prevent new enrollees in Medicaid expansion states from receiving the 9-to-1 enhanced Federal Medical Assistance Percentage (FMAP) if they are able-bodied and don’t have dependent children.
The existing population of Medicaid enrollees in expansion states would keep their 9-to-1 FMAP share, even if they temporarily left the program to join the workforce and then returned.
The reduced FMAP for new enrollees would go into effect in 2031.
A preliminary analysis by the Congressional Budget Office (CBO) projected the Senate bill would reduce Medicaid spending by $930 billion, even without Scott’s amendment to stop the future expansion of the 9-to-1 federal match share in Medicaid expansion states. If it is adopted, it could reduce future Medicaid spending by $1.24 trillion.
CBO found Scott’s amendment would save another $313 billion over ten years, according to his office.
Scott and other conservatives, including Sen. Mike Lee (R-Utah) and Sen. Ron Johnson (R-Wis.), have made a concerted push Sunday to persuade Republican colleagues to vote for the amendment.
The trio of conservatives are not saying whether they will vote for the GOP megabill if their amendment is rejected, hoping to ramp up pressure on colleagues to support the proposal.
Nevertheless, Senate GOP sources expect Scott, Lee and Johnson to ultimately vote “yes” on final passage to support Trump’s agenda.
Senate Majority Leader John Thune (R-S.D.) pledged to Scott Saturday night that he would support the amendment in exchange for Scott’s vote on a critical motion to proceed to the bill.
“I think it’s going to pass. If you think about it, it’s good policy. It gives the states the opportunity to get ready. Nobody gets kicked off,” Scott told The Hill.
Asked if he would vote for final passage of the 940-page Senate bill if his amendment doesn’t pass, Scott said, “I’ll figure it out then.”
“My goal is to support Trump. I like his agenda,” he said.
The amendment is cosponsored by Senate Finance Committee Chairman Mike Crapo (R-Idaho), Sen. Ron Johnson (R-Wis.) and Sen. Mike Lee (R-Utah).
Thune told reporters earlier Sunday that he expects the vast majority of his conference to vote for the amendment, but he wasn’t sure whether it would pass.
“We think it’s really good policy. Yeah, I think a lot of us is going to be supporting it,” he said.
Asked if he had promised Scott it would be adopted to the bill, Thune said: I don’t think you can ever promise.
“Obviously we’re going to do what we can to support the policy,” he said.
Speaker Mike Johnson (R-La.) ruled out changes to the FMAP formula in Medicaid expansion states when the House was putting together its reconciliation bill in early May.
Johnson, the Wisconsin senator and cosponsor of the amendment, said the proposal would roll back a core piece of ObamaCare.
“People are being called and arms are being twisted,” he said. “Nobody loses coverage. … It puts all the states on notice that this gravy train … is going to end.”
Asked if he would vote to pass the bill if the amendment isn’t adopted, Johnson declined to reveal his plans.
“I don’t get flushed out,” he said. “We’re trying to apply as much pressure as possible to get this amendment passed.”
Johnson said if the implementation date was moved up from 2031 to 2030 it would save “$417 billion.”
“It’s real money,” he said.
Updated at 10:19 p.m. EDT
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