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.
Key Takeaways from the Revised Graham-Cassidy Proposal and CBO Preliminary Analysis
Deborah Bachrach and Patricia Boozang, Manatt Health
The brief provides an overview of the most recent changes to the Graham-Cassidy repeal and replace proposal and a just-released preliminary analysis of the proposal by the Congressional Budget Office (CBO). On September 13th, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA)—along with Senators Dean Heller (R-NV) and Ron Johnson (R-WI) and former Senator Rick Santorum (R-PA)—released a new proposal to repeal and replace the Affordable Care Act (ACA). On September 25th, the sponsors released several updates to the proposed legislation. Also on September 25th, the CBO provided its preliminary analysis of one of the earlier versions of the bill.
The key changes in the revised proposal include: additional short-term assistance for low-density states; coverage under the Market-Based Health Care Grants must now meet additional coverage requirements; instead of obtaining “waivers” from federal law, states have new flexibility to offer coverage that does not meet all federal requirements; and states have discretion to allow rating rules that increase premiums for people with pre-existing conditions.