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A top House Republican on healthcare said Tuesday that lawmakers are looking to dramatically restructure Medicaid as part of an ObamaCare repeal bill. Rep. Brett Guthrie (R-Ky.), the vice chairman of the House Energy and Commerce health subcommittee, told reporters that Republicans are looking to include an idea known as "per capita caps" for Medicaid in the fast-track reconciliation bill used to repeal ObamaCare. The comments suggest that Republicans are dealing not just with ObamaCare, but also with restructuring Medicaid as part of their repeal efforts, adding another level of complication. (Sullivan, 2/14)

House Republicans are weighing specific reforms to Medicaid that could be included in a reconciliation measure to overhaul the Affordable Care Act. How to deal with the federal expansion of Medicaid under the ACA is one of the main unanswered questions as Congress works to overhaul Obamacare .... Rep. Brett Guthrie (R-Ky.), the vice chairman of the Energy and Commerce Health Subcommittee, said Tuesday that lawmakers are considering what types of reforms — specifically shifting to per capita allotments or allowing states to choose block grants — could be included in a House reconciliation bill to repeal the ACA. (McIntire, 2/14)

Senators are warning that major changes to the Medicaid program may not survive the upper chamber, despite an aggressive push from House Speaker Paul D. Ryan to include a substantial overhaul of the program in the Republican measure to repeal the health care law. In the House, Ryan and House Energy and Commerce Chairman Greg Walden are pushing their colleagues to consider major Medicaid changes on a repeal bill this spring. Those include funding mechanisms like so-called block grants and per capita caps or a cap on Medicaid enrollment for states that expanded the program under the health care law, according to House aides. (Williams and Mershon, 2/14)

Republicans determined to cut Medicaid may first have to pour more money into it, to keep the peace between Republican governors who expanded health care for low-income people under Obamacare and those who resisted. It’s all part of the GOP’s long-term plan to dramatically revamp the health care entitlement for the poor in order to cap what they see as runaway federal spending. (Haberkorn and Pradhan, 2/15)