As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
Assessment Tool: State Budget Impact of Medicaid Expansion
Deborah Bachrach, Patricia Boozang, and Dori Glanz Reyneri, Manatt Health
Medicaid expansion has generated significant savings and new revenues for states, which they have used to finance spending priorities and to offset state Medicaid costs. States that have expanded Medicaid received over $60 billion in federal funds in 2015 and covered approximately 11 million newly eligible people. This tool, developed by Manatt Health, is designed to help states document the impacts of Medicaid expansion on state budgets, including revenue generation and reductions to state general fund spending on Medicaid and other health related programs and services. This tool can be used to demonstrate the impact of expansion as the incoming administration and the new Congress develop proposals to repeal the Affordable Care Act (ACA), potentially including the Medicaid expansion. The tool provides states with a roadmap to the numbers on Medicaid expansion; how they play out will depend on the final repeal legislation and the choices states make. An accompanying index provides detailed explanations of expansion related costs, savings, and revenue sources outlined in the tool.