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.
Repeal and Replace: Overview of Graham-Cassidy’s Market-based Health Care Allotment
Deborah Bachrach, April Grady, Jocelyn Guyer and Cindy Mann, Manatt Health
This brief, prepared by Manatt Health, 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.
At a high level, the Graham-Cassidy proposal would replace federal funding for Marketplace coverage and some aspects of Medicaid with a capped allotment that would be distributed to states in the form of block grants. States would have significant flexibility to use their block grant funds for coverage, payments to providers or other health care-related purposes.