CNN – As the pressure grows on congressional Republicans to identify cuts in Medicaid, they are crashing into a familiar problem: The changes that could save the most money would impose heavy costs on many of their own voters.
Several key House Republicans have signaled in recent days that they may try to cut Medicaid spending by rolling back the expansion in eligibility for the working poor included in the Affordable Care Act approved under President Barack Obama.
That option may be attractive to Republicans partly because the states that have most aggressively used that authority to expand eligibility mostly lean Democratic.
Most House districts where more people than the national average receive health coverage through the Medicaid expansion are also held by Democrats, according to an exclusive new CNN analysis of data from KFF, a non-partisan health care think tank.
But GOP constituencies would hardly be immune if Congress rescinds the expansion. Nearly three dozen House Republicans also represent districts where the number of people receiving coverage through that Medicaid expansion exceeds the national district average of about 61,600, the analysis found.
And nearly two dozen GOP senators likewise represent states with a substantial population of enrollees covered through the ACA’s Medicaid expansion.
“It’s really a similar pattern that we’ve seen with the Affordable Care Act generally – that it’s become so embedded in the health care system and the lives of people across the country that it becomes very hard to take it away,” said Larry Levitt, executive vice president for health policy at KFF.
Answers on whether the expansion is too entrenched for congressional Republicans to uproot could begin arriving as soon as May 7, when the House Energy and Commerce Committee, which holds jurisdiction over Medicaid, is expected to start marking up the GOP’s massive budget “reconciliation” plan …
