"McConnell appears to be as many as 15 to 20 votes shy of majority support"

Senate Majority Leader Mitch McConnell and Sen. Rob Portman, close allies and typically mild-mannered men, got into a heated exchange over Medicaid at a meeting earlier this week.

McConnell sided with conservatives eager to dramatically slow the program’s growth, and laid into Portman for opposing it.

“As OMB director, you backed entitlement reform,” he said, according to multiple GOP sources in the leadership meeting. Portman was Office of Management and Budget director under President George W. Bush, and McConnell was implying that Portman had changed his stance from when he worked in the White House.