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Whatever happens next with Obamacare repeal and the future of Medicaid will depend in large measure on whether GOP senators choose to fight for the combined 16.8 million of their constituents on Medicaid, including 4.3 million who gained Medicaid coverage because of the Affordable Care Act, according to data from state agencies compiled by HuffPost. ... More than 30 percent of those living in Sen. John Kennedy’s Louisiana, Sens. John Boozman and Tom Cotton’s Arkansas, and Senate Majority Leader Mitch McConnell and Sen. Rand Paul’s Kentucky are Medicaid beneficiaries. More than one-fifth of those living in eight of the other states with Republicans senators are enrolled in Medicaid. (Young and Scheller, 6/2)

State officials and their lobbyists are pressing a group of U.S. senators privately crafting a health care bill to save Medicaid expansion funds under the Affordable Care Act. Federal health care legislation is the top issue coming out of Washington for state lawmakers and governors, state officials tell Bloomberg BNA. Gov. John Kasich (R-Ohio) said he is working with “like-minded” senators and governors to preserve coverage for people “dealing with mental illness, addiction and chronic illness.” In a statement to Bloomberg BNA, he said he was hopeful that senators “will find the right way forward.” (Odom, 5/31)

In his first full budget proposal, President Donald Trump advocates changing the way the federal government funds Medicaid. The fiscal 2018 budget, released last week, was short on details but endorses a bill passed last month by the U.S. House of Representatives that would restrict Medicaid spending for the first time since the program started in 1965. Medicaid is a joint federal and state program that provides health insurance for 77 million poor and low-income people. It cost the federal government $368 billion last year, or about 9% of the national budget. Based on spending, it is the third largest domestic program behind Social Security and Medicare. (McGinty, 6/2)

Although [Bill] George, 52, is homeless, he has health insurance through the state Medicaid program for severely low-income individuals. His Medicaid insurance, paid for by state and federal tax dollars, is through Health Plan of Nevada. But George never received his insurance card, despite listing the downtown homeless shelter as his address. Nor did he receive the welcome phone call for new enrollees, nor the packet of information explaining how his managed care organization works. ... For 16 months, however, the state paid Health Plan of Nevada a monthly fee of up to $563 for George's health insurance. ... And, according to a Reno Gazette-Journal investigation, there were 30,817 Nevadans just like George -- enrolled in a Medicaid managed care plan but not seeing a doctor -- last year. (Damon, 6/1)