Republican Senators Debate Medicaid Expansion Phase-Out June 12, 2017 GOP Medicaid Versus Tax Credit Debate Echoes Democrats CBO Dilemma During ACA – Inside Health Policy Inside Health Policy quoted Manatt’s Cindy Mann, a partner with Manatt Health, for an article on the similarities between Republican senators’ debate over the phase-out of Medicaid expansion funding in the American Health Care Act and Democrats’ decision to write the expansion into the Affordable Care Act. The publication reports that at the time the ACA was written, the Congressional Budget Office score estimated the per-person cost would be lower in Medicaid than in private insurance. Although Senate Republicans are working backwards from the Democrats’ former position, they face similar budget difficulties as they try to design tax credits sufficient for people of low income while also ending Medicaid expansion funding. Mann noted that this cost consideration did account for some part of the Democrats’ decision on Medicaid expansion. However, in the current negotiations the Republican bill would reduce benefits along with per-person funding. Of course now they are proposing much thinner subsidies so the cost per person may be less of an issue, Mann said. They will fall far short of what someone at a very low income needs to purchase coverage.