State Medicaid Block Grants Central to Last Ditch Senate ACA Replace Proposal

NYAPRS Note: GOP Senators are reviewing a last ditch proposal to repeal and replace the ACA offered by Sens. Lindsey Graham and Bill Cassidy, central to which is a the block granting of Medicaid to the states, according to Politico: “The total amount of money available for 2021 through 2026 is $1.2 trillion. The goal is that by 2026, states receive the same base rate for each eligible American. Expansion and non-expansion states start at different points. They are gradually equalized from 2021 to 2026. Some states receive less money than they would under the ACA. But, the Block Grant does not require a state match effectively giving states resources to make up shortfalls.

…In years 2021 to 2023, states are given money based upon how many eligible residents between 50-138% FPL live in the state relative to the total number nationwide. From 2024 to 2026, this changes to a blended formula which in part reflects population and in part the percent of those eligible enrolled in health insurance.”                                       

From Politico Rachana Pradhan describing how the last-ditch Obamacare repeal plan is being pitched to GOP governors by its authors, Sens. Lindsey Graham and Bill Cassidy. “The lawmakers are expected to reveal the full legislation as soon as today, accompanied by Nevada Sen. Dean Heller, and they're trying to move fast: The deadline to fast-track a repeal bill using budget reconciliation is Sept. 30.”

Bill would set aside $1.2 trillion in block grants by 2026: The Graham-Cassidy plan would replace Obamacare funding for Medicaid expansion and private insurance subsidies with block grants, Rachana writes, drawing on documents shared with the governors. Federal funding available for all states would start at $136 billion in 2020 and grow to $200 billion by 2026.

How the formula would work: After a state's block-grant baseline is established in 2020, the bill outlines a block-grant formula that would apply between 2021 and 2023. Starting in 2024, adjustments to state funding would be made to partially account for the percentage of eligible individuals enrolled in coverage the previous year. Major parts of the Affordable Care Act would remain in place until 2020.

— Minneapolis Star-Tribune: "Remaining Obamacare repeal bill still offers the wrong prescription." The paper's editorial board lays out the case against the still-developing legislation, saying that Republicans' focus on eliminating the ACA does little to benefit Americans. "Graham-Cassidy puts political needs before constituents' well-being," the board writes in an unsigned editorial. "Let it die a quiet death — one that marks the end of the GOP's long disingenuous campaign against Obamacare."

— Countdown until reconciliation runs out: 19 days.