Debra Miller

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The American Health Care Act, or AHCA, the proposed legislation to repeal and replace the Affordable Care Act was passed by the U.S. House of Representatives on May 4. The bill contained several major changes to the Medicaid program that, if enacted, would directly impact states’ budgets. CSG estimates the annual state loss of federal Medicaid Funds from the high of $7,210.1 million in California to $16.8 million in Delaware. The median loss is $474.1 million for Connecticut, with half of the expansion states losing less federal funds annually and half of the expansion states losing more federal funds annually.

A new research article featured in JAMA May 8, 2017, found that life expectancy in counties across the U.S. differ greatly and that the disparities are growing.

Life expectancy for children born in 2014 was 79.1 years, with slightly higher expectancy for females –81.5 years – and slightly lower for males – 76.7. But the averages...

How much states spend on children’s health, education, income supports and social services differs greatly according to a just-released Urban Institute report, titled Unequal Playing Field.

The top spending state – Vermont – charted per child expenditures of $13,430, three times as much as Utah’s per child spending of $4,594. The national average was $7,923. Spending in each state was  adjusted for the state cost of living.

Medicaid provides health insurance to more than 70 million Americans who fall within one of four main categories: infants and children; pregnant women, parents and other nonelderly adults; individuals of all ages with disabilities; and very low-income seniors.1 Prior to the passing of the Affordable Care Act, or ACA, in 2010, most low-income adults were not able to qualify for Medicaid because federal law excluded adults without dependent children from the program. Additionally, income eligibility for most parents was extremely limited in most states.2

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.” 

Kaiser Health News has created a special website to keep track of news about changes to the Affordable Care Act. KHN says it will provide analysis, explanation, investigation and data on its site called Repeal & Replace Watch. You can bookmark this on your browser.

A new study from the Commonwealth Fund finds that repeal of two major federal spending provisions of the Affordable Care Act, insurance premium tax credits and the expansion of Medicaid, would ultimately lead to the loss of 2.6 million jobs in 2019. The data, generated by researchers at George Washington, breaks down the impact of repeal for each state. California would lose the most jobs, 334,000 their multistate economic forecasting model suggests, and Wyoming the least with 4,000 jobs lost.

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