Jun, 22, 2017

Resources for States on Medicaid Financing Proposals

A major element of the federal legislative proposals to repeal and replace the Affordable Care Act is a change to the financing structure for Medicaid. The American Health Care Act as passed by the House of Representatives, and the Better Care Reconciliation Act language released by the Senate today, would change Medicaid from a matched entitlement, wherein valid state expenses for Medicaid are reimbursed to the state on a pre-determined match rate, to a capped funding scenario, where the amount of federal support is limited based on a growth rate.

Understanding the effect this funding change will have on Medicaid programs is a critical priority for states. The State Health and Value Strategies program is working to analyze the financing changes from a state perspective. Below are the materials that the program has published to date:

Why Per Capita Caps Aren’t Just Managed Care for States
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.

Webinar: Per Capita Caps in Medicaid: Emerging Issues for States
This webinar 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.

Medicaid’s Role in Public Emergencies and Health Crises
This brief explores the role Medicaid has played 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.

State Medicaid Financing Fact Sheets
These memos are intended to assist states in evaluating how they might fare relative to other states under a capped funding model considering the unique features of each state’s health care landscape.

States and the AHCA: Medicaid Changes in Federal Proposals
This webinar reviewed implications on Medicaid financing, eligibility and other programmatic changes for states.

Medicaid Expansion and Enhanced Match: How Proposals to Grandfather Medicaid Enrollees Could Impact States
This issue brief highlights the experiences of three states and how enrollment freezes impact state Medicaid rolls.

This issue brief considers how much states have accomplished to drive value in and through their Medicaid programs over the last 50 years, and most especially over the last five years, and what states stand to lose in terms of progress and innovation in their Medicaid programs and health care delivery systems if federal support for Medicaid is reduced.