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But the special provision may not be enough to win her vote. Ms. Murkowski is also concerned about two other sections of Mr. McConnell’s bill, one that would cut federal funds for the expansion of Medicaid under the Affordable Care Act and another that would block federal Medicaid payments to Planned Parenthood. The Senate Republican bill sets Medicaid spending targets for each state. A state that exceeds its target is subject to financial penalties. But the bill would tweak these targets “to promote program equity across states.” If a state’s Medicaid spending per beneficiary is more than 25 percent above the national average, its spending target would be reduced by the secretary of health and human services. If a state’s spending is more than 25 percent below the national average, its target would be increased. These adjustments must be made in a way that does not increase federal spending, so states will, in effect, be vying with one another for a limited pot of federal money.

For the original version including any supplementary images or video, visit https://www.nytimes.com/2017/06/25/us/politics/mitch-mcconnell-senate-health-care-bill.html

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