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House GOP Eyes Medicaid Reforms in 2017, Depending on November Outcomes

A House Republican task force is weighing what types of Medicaid reforms could be possible in 2017, though the November election will play a major role in what can be done, its leader said Tuesday.

Reauthorizing the Children’s Health Insurance Program and some Medicare extenders could provide provide opportunities for some additional reforms to the Medicaid program, Rep. Brett Guthrie (R-Ky.) said Tuesday at a Mercatus Center forum about policy reforms. But he conceded that which political party controls the Senate and the White House, and whether Republicans retain their House majority, will dictate how much can be done.

“It’s coming to the point that states are going to need it,” he said. “Most states are going to demand it.”

States and the federal government share the costs of Medicaid, but at least in Kentucky, state costs are taking up other priorities, such as higher education, Guthrie said. The GOP Energy and Commerce Committee task force, which is looking at the issue, is trying to learn more about the program to better prepared to seek reforms next Congress.

“No matter how it falls out, I don’t think we’re going to get away with health care spending in this country not being addressed over the next four years,” Guthrie said. “We’ve gotten away with it for the last eight in a lot of ways, and a matter of fact expanding health care over the last eight, but I don’t think we’re going to in the next four.”

The group doesn’t currently have a specific plan to produce a white paper or report by a certain time, but could release some recommendations this year.

Regardless of the possible scope of reforms, each state’s different way of running Medicaid poses a signifiant challenge to updating the program, Guthrie said.

For example, he said that in Kentucky there should be a way to acknowledge the population of people who are eligible for Medicaid under the expanded program from traditional beneficiaries, as they may not require all of the same benefits.

Any reforms should include a way for people to “work off Medicaid” by ensuring that beneficiaries don’t forfeit a job at risk of losing insurance, he told reporters after the event.

“The concept is that you have the ability to work and maintain your Medicaid until you can get to a position where you can hopefully do insurance, that access to quality health care doesn’t prevent you from going to work,” he said.