Debra Miller

Remember that after the Affordable Care Act passed, numerous commentators predicted that increased insurance coverage, achieved through purchase of individual plans through the ACA marketplace or expanded Medicaid coverage, would precipitate a primary care shortage? Experts feared that those with new coverage would not actually have access to care and those previously insured might experience decreased access to primary care. Studies have shown that primary care availability hasn’t suffered as expected.

The bill proposed this week by Senators Graham and Cassidy would repeal many provisions of the  Affordable Care Act and redesign the Medicaid program. Through 2026 the federal government would  provide each state a block grant in lieu of funding for Medicaid expansion and subsidies for health insurance purchased through the ACA marketplaces. Federal funding for Medicaid, absent the expansion, would be converted to a per capita cap basis, reducing federal expenditures over time. After 2026, the block grant would disappear. The bill would also eliminate consumer insurance protections of the ACA including prohibitions against annual and lifetime limits and underwriting practices related to pre-existing conditions.  

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. 

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...