Representative Brett Guthrie (R-Kentucky), vice chairman of the House Energy and Commerce health subcommittee, has told reporters that Republicans are planning to dramatically restructure Medicaid as part of the fast-track reconciliation bill that will used to repeal most of the Patient Protection and Affordable Care Act (PPACA), according to a report from The Hill.

The restructuring would include an idea known as “per-capita caps,” also called a per-capita allotment. Under this plan, Medicaid’s current open-ended commitment would shift to a capped payment from the federal government to states. The payment amount per person would be capped, providing more flexibility than the similar idea of a block grant, which is a set amount of money regardless of the number of enrollees.

Republicans view per-capita caps as a way to limit federal spending and to give more power to the states, but Democrats claim that by capping spending, harmful cuts to people’s Medicaid benefits would be inevitable.

What to do about the expansion of Medicaid is still a work in progress, Guthrie said.

“We have a lot of members from expansion states,” he noted. “So how do we deal with that and reform Medicaid at the same time?”

Source: The Hill; February 14, 2017.

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