The expiration of Children’s Health Insurance Program (CHIP) funding on September 30, 2017 raises four critical issues for states: 1) the timing of reauthorization, and what the level of allotment and duration of any extension will be, 2) whether the 23 percent increase to federal matching funds will continue, 3) whether maintenance of effort (MOE) requirements will continue unchanged, and 4) operational considerations for states, including notices to members and budget planning.
In a final effort to pass a bill to repeal and replace the Affordable Care Act before reconciliation instructions expire on September 30th, Senators Graham and Cassidy are advancing a proposal that would retain many key provisions of the Better Care Reconciliation Act (BCRA) – including per capita caps for Medicaid non-expansion populations – and replace federal funding for tax credits, cost sharing reductions, Medicaid expansion, and the Basic Health Program with a capped allotment that would be distributed to states in the form of a block grant.
An overview of the proposal released on September 13th by 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)—to “repeal and replace” the Affordable Care Act (ACA). This is an updated version of the proposal that Senators Graham and Cassidy filed on July 27th. The Graham-Cassidy Affordable Care Act (ACA) repeal and replace legislation would retain many features of the Better Care Reconciliation Act (BCRA) voted down by the Senate on July 25th, including per capita caps on Medicaid spending and elimination of the individual and employer mandates. However, it also goes beyond that proposal by converting Marketplace and Medicaid expansion federal funding into a block grant.
Federal funding for the Children’s Health Insurance Program (CHIP) is set to expire on September 30th, raising multiple issues for states. State Health and Value Strategies, in partnership with technical experts from Manatt Health, hosted a webinar to discuss key considerations for states as Congress debates CHIP reauthorization. Topics included the funding level and duration of the extension, maintenance of the 23 point FMAP bump, maintenance of effort requirements, and operational implications of reauthorization timing.
This brief provides an overview of the proposal developed by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) and filed on July 27th as a substitute for the American Health Care Act passed by the House to “repeal and replace” the Affordable Care Act (ACA). The proposal retains many features of the July 20th version of the Better Care Reconciliation Act (BCRA) released by Senate leadership (and rejected by the Senate on July 25th), including per capita caps on Medicaid spending and elimination of the individual and employer mandates.
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 issue brief digs into opportunities that states have to account for SDOH in Medicaid programs.
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.