Senate Republicans continue to push for legislation to repeal and replace the Affordable Care Act. The Graham-Cassidy bill is sponsored by Senator Lindsey Graham, from South Carolina and Senator Bill Cassidy, from Louisiana. Although the bill is still lacking 50 votes needed, it is important to understand the effects it may have on health care.
This proposal would dismantle the Medicaid expansion and affect the subsidies that are used to help people afford insurance. “The Graham-Cassidy proposal will remove the safety net that has guaranteed insurance for the poorest citizens of the country.” Larry Levitt, a senior vice president with the nonpartisan Kaiser Family Foundation has stated, “this is by far the most radical of any of the Republican health care bills that have been debated this year.”
There are many states that will gain and lose federal funding for Medicaid under Graham-Cassidy. Under the proposed legislation, from 2020-2026 it is projected that New York Medicaid’s funding will decrease anywhere between 5% and 10% for a total of about $45 billion. In contrast with New York, which had supported Medicaid’s expansion under Obamacare, Texas will see an increase of $35 billion. There are a total of thirty-four states that will receive less federal dollars under the Graham-Cassidy proposal, including states such as Pennsylvania, Ohio, Colorado and Michigan.
Overall there will be a lot of Medicaid spending cuts that will affect millions of Americans protected under the program. Under this new proposal, the Medicaid expansion funds that were used under Obamacare to expand healthcare to include people living within 138% of the poverty line, will be turned into block grants by 2020. By 2027, they are projected to disappear completely. Children and non-disabled adults will be hurt the most by the decrease in federal funding. In order to supplement the funding drops, states will have the discretion of using the block grant funds as they see fit to help those insured, but they are not required to do so. The money could be used for a variety of healthcare expenses, including:
- Creating high-risk pools
- Creating a health care exchange
- Subsidize the cost of premiums or out-of-pocket costs for people covered by private insurance
A total of 74 million Americans are currently insured through Medicaid. Although many of them are poor, Medicaid also covers people with disabilities, children, and elderly. The federal government and states have shared the cost of Medicaid, with the federal government paying between 50% and 75%, according to Medicaid.gov. Under Graham-Cassidy, the federal government will have the discretion to cap Medicaid spending on a per-person basis.
Graham-Cassidy would essentially put federal spending on a budget and make the most impactful changes to Medicaid since 1965. The cap that would be put on a per-person basis is worrisome to hospitals. Hospitals have the duty to give a certain level of care to patients, no matter if they can pay or not. Twenty-percent of hospitals already spend more than they receive. The proposal would also allow states to stop requiring insurers to cover expenses such as hospitalization, prescription drugs, maternity care, and mental health treatment. Although Senator Cassidy insists that the bill will still protect anyone will a chronic illness, the proposal is written in a way that would allow insurance companies to charge a higher rate for patients that are pregnant or even have cancer.
Medicaid pays for the largest share of coverage for the elderly, children, poor adults, and disabled members of society. With the Republican’s push to repeal and replace the Affordable Care Act, it is especially important to understand your rights and options. The professionals at P&P Medicaid Consulting, Inc. assist Nassau County, Suffolk County, and Queens residents in preparing applications for Medicaid eligibility while taking advantage of programs and planning options that will protect their income and assets. For more information or to schedule a consultation, call our Long Island, New York Medicaid consulting office at (516) 541-4770 or fill out our contact form.