Medicaid: What Happens Now?

With public attention completely focused on the wild effort to reach closure on the private health insurance provisions of the American Health Care Act (AHCA) (H.R. 1628), it was easy to overlook (at least for a moment) the extraordinary nature of its Medicaid changes. Were these provisions to become law, the AHCA would represent the most sweeping federal policy shift since the program’s 1965 enactment. How The AHCA Would Affect Medicaid The AHCA would end the Affordable Care Act’s enhanced funding for the adult expansion population. More profoundly, however—and completely disconnected from the AHCA’s “repeal and replace” purpose—the legislation would make seminal changes in how the federal government finances its share of Medicaid, affecting more than 74 million people. This alteration in Medicaid’s basic financing structure would come in the form of fixed upper limits on what the federal government contributes to each state’s per-enrollee spending, adjusted over time only for medical inflation, and without further adjustments for changes in the volume and intensity of care, provider payment reforms aimed at enhancing participation, or the introduction of new technologies. According to the Congressional Budget Office (CBO), over the 2017–26 time period, the AHCA ultimately would cost states $880 billion in federal funding—a 25 percent federal funding reduction by 2026. This federal spending reduction would result from the combined effect...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Medicaid and CHIP Quality ACA repeal and replace AHCA EPSDT Medicaid block grants Medicaid expansion Medicaid per capita cap medicaid work requirement Source Type: blogs