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.
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.