Federal Healthcare Reform

Proceedings of the Medicaid 201 Leadership Policy Academy, Sept. 13-15, 2017

 

Robin Rudowitz, associate director, Kaiser Commission on Medicaid and the Uninsured

 "Medicaid Landscape: What We Learned and What to Watch," click 

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On Aug. 30, Ohio Gov. John Kasich and a bipartisan group of 7 other governors released a letter to congressional leaders that outlines reforms Congress should consider to strengthen states’ health insurance markets. 

The latest version of the Senate’s Better Care Reconciliation Act, or BCRA, was released July 20, 2017. According to the CBO analysis, the new version of the BCRA would reduce federal deficits by $420 billion over the 2017-2026 period, the net result of a direct spending decrease of $903 billion partially offset by a $483 billion decrease in revenues. Of special interest to states, the reduction in Medicaid spending is $772 billion, or 85 percent of the reduced spending, directly impacting states’ budgets. The effects of the bill on the number of uninsured is little changed from the earlier version. In 2018, 15 million more people would be uninsured than under current law and would reach 22 million in 2026.

Last week in Washington, D.C. 27 state legislative leaders gathered for the sixth annual CSG Medicaid 101 Policy Academy. Attention was focused on the Medicaid reform plan, called the Better Care Reconciliation Act of 2017, under consideration in the U.S. Senate following the House approval of the American Health Care Act in early May. CSG prepared a brief side-by-side comparison of the...

CSG Midwest
On May 3, the U.S. House of Representatives passed the American Health Care Act (AHCA) to replace the Affordable Care Act (ACA).
CSG Midwest
Last summer, as insurers filed their individual health insurance plan rate premiums for 2017, it became clear that something was wrong: Rates in 31 states shot up by double digits (triple digits for Arizona); overall, the average increase in premiums was 25 percent....

The Urban Institute released an analysis of the state-by-state impact of the AHCA, 2019 to 2028. The Urban Institute looked at the impact of the proposal on state funding (see Table 5). If states made up for the loss of federal funds with state funds, it would require a 16.1 percent increase in all states' Medicaid spending over the ten year period. 

Yesterday the Congressional Budget Office – or CBO – released its cost estimate for the House Republican plan to repeal and replace the Affordable Care Act. All told, the report says, the federal deficit would be reduced by $337 billion over the 2017-2026 decade. Reducing the federal deficit is welcome news to most federal policymakers.

On Monday, March 6, the House Republicans released the American Health Care Act, the measure intended to fulfill their campaign pledges to repeal and replace the Obama administration Affordable Care Act. Here is the summary provided by the House Republicans. 

Of primary interest to state policymakers, the House plan implements a per capita cap in Medicaid funding, beginning in 2020, based on FFY 2016 spending levels. The House Republican plan has not been scored by the Congressional Budget Office so there are no publicly available data on how much this change will cost states and save the federal government.

Yesterday, in response to concerns about insurers pulling out of the ACA marketplaces and raising premiums, the federal government published proposed rules to stabilize the individual and small group health insurance markets.

In a press release, Dr. Patrick Conway, Acting Administrator of the Centers for Medicare & Medicaid Services acknowledged the changes are short term relief “while future reforms are being debated.” 

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