Issue Briefs | Aug 11, 2017

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.


Expert Perspectives

September 6, 2024

Current Considerations for State Reinsurance Programs

Reinsurance is a long-standing tool for stabilizing health insurance markets and reducing premiums, and has played an important role in the success of the Affordable Care Act’s individual market as part of section 1332 state innovation waivers. Reinsurance increases affordability for consumers ineligible for the premium tax credit (PTC). However, the effects on PTC recipients are smaller, mixed, and have received little attention. This expert perspective summarizes recent research which raises questions about the impact of reinsurance programs on PTC recipients, and highlights related considerations for state policymakers.

CMS Issues Guidance on Renewal Timeliness Post-Unwinding

On August 29, 2024, the Centers for Medicare & Medicaid Services (CMS) released a CMCS Informational Bulletin (CIB) and accompanying slide deck to support states facing renewal backlogs. With this guidance, CMS is providing states additional time—until December 31, 2025—to complete Medicaid and CHIP eligibility renewals, address persistent backlogs in processing redeterminations, and achieve compliance with federal renewal timeliness requirements. This expert perspective provides an overview of the CIB.