Sunday, July 30, 2017

Cassidy-Graham Amendment Would Cut Hundreds of Billions from Coverage Programs, Cause Millions to Lose Health Insurance | Center on Budget and Policy Priorities

The GOP just does not think that healthcare is a right. -gwc
Cassidy-Graham Amendment Would Cut Hundreds of Billions from Coverage Programs, Cause Millions to Lose Health Insurance | Center on Budget and Policy Priorities 
Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) have introduced an amendment to the GOP health bill that they describe as focused on state flexibility and equalizing payments across states rather than cuts.[1] But the amendment would make drastic cuts to both Medicaid and marketplace financial assistance
Specifically, the Cassidy-Graham amendment would:
  • Eliminate premium tax credits and cost-sharing reductions that help moderate-income marketplace consumers afford coverage and care, and eliminate the ACA’s enhanced match for Medicaid expansion starting in 2020.
  • Replace the marketplace subsidies (premium tax credits and cost-sharing reductions) and Medicaid expansion funding with a block grant set at levels well below what would be provided under current law.  States apparently could use these funds for a broad range of health care purposes, not just coverage, with essentially no guardrails or standards to ensure affordable, meaningful coverage.  After 2026 block grant funding would end altogether.
  • Maintain the Senate bill’s provision to convert virtually the entire Medicaid program to a per capita cap, with large and growing cuts to federal funding for seniors, people with disabilities, and families with children.  
As a result of these provisions, the Cassidy-Graham proposal would:
Make deep cuts to federal funding for coverage programs.  Block grant funding in 2020 would be $26 billion, or 16 percent, below projected current law federal funding for Medicaid expansion and marketplace subsidies.  The block grant would grow by only 2.0 percent annually, well below medical cost inflation and even general cost inflation.  By 2026, block grant funding would be $83 billion, or 34 percent, below projected current law federal funding.  States would be forced to sharply scale back coverage as these block grants became increasingly inadequate. 
Moreover, the formula for how much states receive under the block grant would move federal funding from expansion states to non-expansion states, deepening the percentage cuts to funding for expansion states. That would punish states that have been most successful at enrolling low- and moderate-income people in coverage since the ACA’s major coverage expansions took effect.  In fact, Senator Graham said on the Senate floor that funding for California, a state that with a highly effective state-based marketplace and a successful Medicaid expansion, would eventually be cut by 38 percent.  The amendment appears designed to pick winners and losers, rather than guarantee states the funding they need to cover their residents’ needs.  Also, because the funding is conditional on meeting certain criteria related to states’ per capita income, population density, and Medicaid expansion status, some states (such as Florida, North Carolina, and Virginia) would be excluded from between 45 and 70 percent of the funding outright. 
Crucially, funding would end altogether after 2026, leaving states with massive holes in their budgets and no choice but to further reduce access to coverage.

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