The fiscal hawk is at the center of the Senate GOP’s negotiations on Medicaid, pushing for changes that would squeeze its budget even more by reining in the growth of one of the government’s most expensive and politically fraught programs.“Medicaid is growing at an unsustainable pace,” Toomey said, noting that it is expanding faster than the economy. Some Senate Republicans who, like Toomey, represent states that have expanded Medicaid to millions of new beneficiaries under the Affordable Care Act are also pushing back against the belt-tightening.Fish-scale geckos (Geckolepis maculata) have large scales, large legs and are cream in color with black bands.According to the IUCN, the species is widely distributed in Madagascar and thought to occur from northern to southeastern Madagascar including the offshore island of Nosy Be.Toomey would take another House provision and make it even more strict.He would tighten proposed caps on Medicaid spending by using a less generous measure of inflation for adjusting those limits every year.(Currently the program is open-ended, so spending rises with costs and enrollment.) Stier, citing CBO inflation projections, estimated that by 2026 such a change would cost Pennsylvania more than billion a year in federal support, though Toomey’s office cast doubt on the CBO figures.Cassidy argued that such a strict cap would leave states hamstrung in the face of a boom in health-care costs brought on, perhaps, by developments like the AIDS epidemic or opioid crisis.
When Madagascar's fish-scale geckos perceive a threat, they resort to an extremes to protect themselves - tearing out of their own skin.That shift would cost Pennsylvania more than .7 billion per year starting in 2020, according to the Wolf administration. Christie has said the expansion has saved his state billions since it began.If such cuts come to pass, according to analysts, Democrats, and some Republicans, cash-strapped states would be forced to reduce benefits, limit eligibility, or raise taxes to make up the difference. “What they’re saying is: Their state governments would decide that it’s not worth it to us to have these people on Medicaid when we can buy it at 43 cents on the dollar,” Toomey said in an interview.Toomey said Wednesday that there was little progress on a compromise.“I don't know how we get to 50 [votes] at the moment.But that’s the goal,” Senate Majority Leader Mitch Mc Connell told Reuters last week.