Graham-Cassidy: A Closer Look At The Medicaid Provisions

As Tim Jost notes in his post on the proposal, the newest version of Graham-Cassidy aims to create a system—at least in the short term—in which, via a new, temporary block grant, all states would receive some amount of federal resources to provide at least some level of coverage to certain populations who would be ineligible for Medicaid. But this short-term pooling arrangement appears to suffer from a number of significant limitations. These limitations begin with its short-term nature, of course (the pool ends in 2026 and what happens after that is anyone’s guess). In addition, however, the funding formula on which the pool rests, which supposedly accounts for the population that was previously insured (or that could have been insured) through the ACA’s Medicaid expansion, appears not to account for a significant proportion of the expansion, suggesting that the approach is deeply underfunded. Thus, even though the FAQ accompanying the proposal says that it “would replace the federal money spent on [among other things] Medicaid expansion,” in fact there appear to be millions of people missing in light of the way in which the allocation formula is designed. The loss of federal Medicaid expansion financing and its replacement with a time-limited partial, capped fund, represents only part of Graham-Cassidy’s Medicaid plan. Like the earlier Senate GOP Better Care Reconciliation Act, from which Graham-Cassidy borrows, the measure also would fundamentally a...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage ACA repeal and replace Source Type: blogs