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Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, told moderate GOP senators at a White House meeting Wednesday that the administration is willing to hammer out a new Medicaid proposal. The latest proposal, which senators are calling a “Medicaid wrap-around,” would give states more flexibility to use Medicaid funding to cover the healthcare expenses of people outside the program who face high healthcare costs. (Bolton and Sullivan, 7/19)

In a bold move to revive their healthcare bill, Senate Republican leaders are getting ready to propose giving $200 billion in assistance to states that expanded Medicaid, according to a person familiar with internal Senate negotiations. The huge sum would be funded by leaving in place ObamaCare’s net investment income tax and its Medicare surtax on wealthy earners, according to the source briefed on the proposal. ... The windfall for Medicaid expansion states would come on top of a proposal that Seema Verma, the administrator of the Centers for Medicare and Medicaid, made to moderate GOP senators at a lunch meeting at the White House on Wednesday. (Bolton, 7/19)

A GOP strategy of attaching a major Medicaid overhaul to their health care bill has made it more difficult for Republicans to make good on their seven-year promise to roll back the 2010 health care law, budget experts say. “Had Medicaid been not a part of the House bill or the Senate bill, I think we would be having a much different discussion than we’re having today,” said G. William Hoagland, a senior vice president at the Bipartisan Policy Center and longtime Senate aide on budget issues. (McIntire, 7/19)

Tymia McCullough fidgets in front of a mirror in her hotel room as her mom, Susie Pitts, puts the final touches on her hair and nervously drills her on what she is going to say when she gets to Capitol Hill. "And this is where you let them know that Medicaid is what?" Pitts asks. "Health assurance," Tymia responds."Health insurance that does what?" "It pays for the need to see your doctor," Tymia says. (Kodjak, 7/19)

In the Netherlands, the government sought to give people more “skin in the game” in its national health system. The idea — long supported by U.S. conservatives, even for poor people on Medicaid — is that when patients have to shell out some cash for their care, they won’t seek unnecessary services. In 2012, the Dutch government imposed mandatory co-payments for mental-health care on adults but not children .... The result: Adults’ use of regular mental-health services abruptly dropped 13.4 percent for both severe and mild disorders. The decline was even sharper for poor people. For children, who had no co-pay, there was no appreciable change. (Sapatkin, 7/19)

One of the primary reasons the Senate Republicans' proposal to repeal and replace the Affordable Care Act failed to get enough votes is because of how it would have cut Medicaid spending. Children's hospitals are particularly concerned about the possibility of Medicaid cuts, and the impact on children. (Young, 7/19)

People who work at hundreds of rural hospitals are also watching [the national debate on a health care bill] closely. Those hospitals have struggling budgets that were propped up by the massive influx of poor people who gained taxpayer-funded health insurance. The transformation has been especially dramatic in Kentucky, where rural hospitals are not just a lifeline for patients who may not have the means to travel far for the help they need. They also sustain local economies, providing jobs and services that people there have come to see as indispensable in some of the nation's poorest and most isolated communities. (Beam, 7/19)

Clinton attorney Ronald Morton helps the elderly protect their stuff — sometimes so they can use Medicaid to pay for long-term, end-of-life health care as opposed to spending their savings. ... While Mississippi lawmakers discuss cracking down on the state's growing Medicaid rolls by vetting applicants more closely, this is not a scenario that enters the conversation. ... In Mississippi, three out of four nursing home residents receive Medicaid benefits. That's 13 percent more than the national average. But it is difficult for Medicaid officials to determine how much of an impact "Medicaid planning" has on the state. ... [Morton] says, most of his clients are middle class. (Wolfe, 7/20)

Health advocates are warning that dentists across Iowa may stop accepting Medicaid patients because of the state's move to shift management of the dental system to for-profit companies. A clause in the new contracts signed with those for-profit management companies says dentists who accept Medicaid can't discriminate against patients based on their eligibility to enroll in the program. (Clayworth, 7/18)

Iowa’s shift to a privately managed Medicaid system continues to draw more detractors than fans, a new Des Moines Register/Mediacom Iowa Poll shows. Forty-seven percent of Iowa adults think the state should go back to having a state-run Medicaid system, according to the poll. Thirty-seven percent think the state should continue to have private companies run the program. Sixteen percent are unsure. (Leys, 7/19)