A report detailing what Medicaid funding cuts would occur under the Better Care Reconciliation Act (BCRA) was made by Avalere Health to the National Governors Association recently. Presentation slides were obtained by Politico. The presentation covers both Medicaid and private health insurance provisions within the BCRA and how they would impact states in terms of funding and coverage. It goes through the impact of converting Medicaid to either a per capita cap system or a block grant, both options under the latest draft of the Senate health care bill.
While federal funding levels for all populations would decrease, the largest decrease would be in the Medicaid expansion population that was added as part of the Affordable Care Act (ACA). Overall disability funding would be reduced by approximated 24% over two decades. The steepest decline would come after 2025, when the rate of growth would change from CPI-M (Consumer Price Index for Medical expenses)+1 to CPI-U (CPI for Urban markets). The report notes that all states would experience lower funding levels, but the impact would vary widely state to state. Some actions states might take in response to the reduced funding would be to tighten eligibility criteria, limit covered benefits, increase beneficiary cost sharing, reduce provider payment rates, and identify other sources of funding, including raising state taxes.