Webinar — Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Following our June 5th webinar, “Per Capita Caps Under Medicaid: Emerging Issues for States,” State Network, in partnership with technical experts from Manatt Health, is hosting a series of conversations that will provide opportunities for state leadership to dive deeper into emerging issues. Given the recent release of the Senate repeal and replace proposal, we will review and discuss the Senate’s BCRA. State Network, in partnership with technical experts from Manatt Health, will host a webinar during which we will review the major Medicaid provisions of the BCRA, providing an opportunity for state leadership to understand how the Senate bill compares to the AHCA and its potential implications for states. This session will start with a short presentation, followed by time for Q&A and a discussion, focusing on the Medicaid provisions of the BCRA.
Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Senate leadership has released a proposed substitute for the House-passed American Health Care Act (AHCA) known as the Better Care Reconciliation Act of 2017 (BCRA) that eliminates enhanced funding for Medicaid expansion after a three-year phase out, establishes a cap on federal Medicaid funding for nearly all beneficiaries and services, and makes a number of other changes to Medicaid. Using the Manatt Medicaid Financing Model, this analysis estimates the state-by-state impact of the cap on Medicaid and elimination of enhanced funding for expansion, taking into account that states may respond to the proposed law in a number of different ways.
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This webinar includes an overview of the methods for gathering SDOH data, and the range of possible uses of the data by state policy makers. It also explores how states could factor SDOH into improved payment models and quality measurement activities. Lastly it describes a new payment model that Massachusetts Medicaid is using to adjust managed care payments for certain social risk factors among enrolled populations.
The American Health Care Act (AHCA), as passed by the House of Representatives on May 4, 2016, would overhaul federal financing of state Medicaid programs, and for the first time, would cap federal Medicaid funding. As policymakers debate the potential implications of per capita caps, it has been suggested that per capita caps are really no different than Medicaid managed care—a concept with which states are fully familiar and well able to manage. This policy brief tests that hypothesis by examining the similarities and differences between the federal per capita cap and a state’s per capita “cap” in Medicaid managed care spending.
Following the House’s passage of the American Health Care Act (AHCA) and the Senate’s on-going repeal and replace negotiations, it is clear that significant changes to federal Medicaid financing remain in play. Building on past State Network webinars that have reviewed the AHCA Medicaid financing provisions and identified their implications for states, the State Network, in partnership with technical experts from Manatt Health, held a webinar that provided a deep-dive on critical issues that will influence the impact of capped funding on states, including choice of base year, trend rates, and treatment of supplemental payments. The discussion was informed by updated modeling based on the House-passed version of the AHCA.
Medicaid’s unique and critical role in responding to events such as the opioid and HIV/AIDS epidemics, the 2001 World Trade Center attacks, the Flint, Michigan lead contamination crisis, and Hurricane Katrina are discussed in this brief.
Driven to improve care coordination and contain costs by moving away from a volume-based payment model, an increasing number of states are implementing risk-based managed care programs to deliver long-term services and supports (LTSS). As the primary payer for LTSS, state Medicaid programs have a significant interest in ensuring that entities with which they contract deliver high quality and cost-effective care to members. This issue brief identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.
Health Savings Accounts have been a frequent topic of conversation for policy options in the ACA markets. HSAs have gained attention in recent years as they are featured in both “Repeal & Replace” and Medicaid proposals. This webinar reviewed the basics of HSAs, how they have been considered under various repeal and replace proposals, and how alternative Medicaid expansions have used HSA-like programs for enrollees.
As states seek to understand the impacts of proposed changes to Medicaid financing, comparative data on where states stand can be very valuable. The memos included here use state-specific data to analyze the impact of proposals to limit federal Medicaid funding on all 50 states and the District of Columbia.
The American Health Care Act has a number of policy changes that impact state Medicaid programs. This webinar featured experts at Manatt Health as they review implications on Medicaid Financing, Eligibility and other programmatic changes for states. The attached slides provide significant insight into eligibility changes, the policy principles of the per capita cap and block grant models, and an in-depth explainer of the creation of per-capita caps for states.