Debra Miller

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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...

Earlier this week, I spoke with Ohio Rep. Al Landis about a media campaign he has started to bring attention to the opioid crisis in his legislative district and spread a message about prevention. He calls it #gotyourback.  He asks people to post on his own personal Facebook page a picture of themselves back to back with a friend and the words “I’ve got your back! It’s what friends do. Help your friends say no to drugs.”

The campaign springs from his growing alarm about the opioid crisis in Ohio.

The president's federal budget was released May 23 and the analysis of winners and losers began practically before the ink was dry, although almost all of Washington seemed to agree the budget was dead on arrival. Cuts to the Medicaid and Children's Health Insurance Program, or CHIP, alone total $616 billion over the next ten years. The budget also envisions saving $250 billion from partly repealing and replacing the 2010 health care law. Taken together, these Medicaid cuts are nearly half the nondefense discretionary funding cuts. To further understand just how important federal Medicaid funds are to states, CSG looked at 2017 federal funding flowing to the states. According to Federal Funds Information for the States, or FFIS, data, the federal Medicaid funding for 2017 is more than 50 percent of all federal grant funds flowing to states in all but four states.

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.

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