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Changes to Medicaid included in the House Republican health-care bill would usher in the biggest structural overhaul ever to a program that covers roughly one in five Americans, or more than 70 million people. The bill, if passed by both chambers, would transform an entitlement program, in which everyone who qualifies has a right to health coverage, into a system where that is no longer guaranteed. (Armour, 3/22)

For all its populist design, the House GOP’s latest proposal to overhaul federal Medicaid funding creates financial risks for states and could leave some enrollees worse off. Dramatic changes in Medicaid are a big part of the House bill to partially repeal the Affordable Care Act that’s steaming toward a floor vote scheduled for Thursday. Big revisions were made to the legislation this week to appeal to conservatives pushing to reduce federal Medicaid spending and shift more power to states. (Galewitz, 3/22)

But advocates for the elderly now worry that [Carmencita] Misa and other low-income seniors who receive long-term care in facilities or at home could see their benefits shrink or disappear under Republican-proposed legislation to cap federal Medicaid contributions to states. The proposal is part of a broader GOP plan to repeal and replace former President Barack Obama’s Affordable Care Act. (O'Neill, 3/22)

Governors are analyzing the House Republican bill to restructure Medicaid and phase out the Obamacare expansion of the program, and they don't like what they see. That prompted four Republican governors from Medicaid expansion states—John Kasich of Ohio, Rick Snyder of Michigan, Brian Sandoval of Nevada and Asa Hutchinson of Arkansas—last week to offer their congressional colleagues a sharply different Medicaid proposal. In their letter, they wrote that the House bill “provides almost no new flexibility for states, does not ensure the resources necessary to make sure no one is left out and shifts significant new costs to states.” (Meyer, 3/21)