One of the thorniest issues for Republicans is how to handle the Affordable Care Act’s expansion of Medicaid.

The Hill:
Early Splits Appear As Senate Republicans Confront Medicaid Choice

Republican senators hailing from states that took ObamaCare’s Medicaid expansion are taking different tacks on defending the program as much of their party looks to end it. Sen. Rob Portman (R-Ohio) told reporters Tuesday that he supports rolling back the Medicaid expansion by ending the extra federal money for it, as long as there is a “soft landing.” But Sen. Shelley Moore Capito (R-W.Va.) told The Hill that she wants the expansion of coverage to remain, though she said it did not have to be in the same form. (Sullivan, 5/9)

CQ Roll Call:
Medicaid On The Agenda In Multiple Senate Meetings

Senators from states that expanded Medicaid met Tuesday to discuss issues such as how proposed tax credits could help consumers who enrolled in the federal-state program through the health care law’s expansion, said Sen. Rob Portman, R-Ohio. The meeting was separate from another discussion on Medicaid held later among the senators tapped for a health care working group by Majority Leader Mitch McConnell, R-Ky. Portman, who said he has been talking with about 20 senators, met Tuesday with at least half a dozen Republicans from states that broadened Medicaid eligibility to the working poor under the 2010 health care law.  (Young and Mershon, 5/9)

The Washington Post:
Who Will Decide What The Senate’s Health Bill Looks Like? Follow The Medicaid-State Senators.

The Senate has broken into a series of “working groups” to begin writing its own version of legislation to replace the Affordable Care Act. There’s the leadership-driven group, a group of moderates and there was talk about a more conservative group before it was mostly absorbed into the leadership group. But the most powerful bloc in the Senate, based on the size and clout of its members, are the Republicans who come from states that took advantage of the 2010 health law’s federal expansion of Medicaid to provide insurance to millions of lower-income Americans. (Kane, 5/9)

Morning Consult:
Opioid Crisis At Heart Of Medicaid Debate For Some Senators

Medicaid is becoming the Senate’s first focus as lawmakers try their hand at a bill to repeal and replace major parts of the Affordable Care Act. Though the topic received less attention in the House, how the replacement to the ACA treats expansion of the federal program for low-income Americans is set to be a major component of debate in the Senate. The opioid crisis is at the center of the issue for some Republican senators who represent states that expanded Medicaid. (McIntire, 5/9)

Bismark (N.D.) Tribune:
Proposed Medicaid Expansion Rollback Could Impact 20K Enrollees In North Dakota

Proposed changes to expanded Medicaid making their way through Congress would effectively eliminate a program that has about 20,000 enrollees in North Dakota, the state’s lone congressional Democrat warned this week. … the American Health Care Act would spell the end for Medicaid expansion, said Sen. Heidi Heitkamp, D-N.D., who derided the bill as a tax break for the richest Americans that would leave more people uninsured. “The American Health Care Act is a horrible piece of legislation,” Heitkamp said in an interview Monday. She has pushed for fixing parts of the current law instead of repealing it. (Hageman, 5/9)

Detroit News:
Lyon: House Health Bill Threatens Medicaid Expansion

The U.S. House health care overhaul legislation approved last week could trigger the end of the state’s Healthy Michigan Medicaid expansion program or require legislators to make major changes, the state’s health director said Tuesday. It would cost the state roughly $800 million a year to continue the low-income insurance plan on its own if federal funding is reduced to the standard matching rate for other Medicaid enrollees, said Michigan Health and Human Services Director Nick Lyon. (Oosting, 5/9)

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