Capitol Correspondence - 07.03.17

Medicaid Directors Issue Strong Statement on BCRA

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On June 26, the Board of Directors of the National Association of Medicaid Directors (NAMD) issued a statement on the Better Care Reconciliation Act. According to NAMD, the statement “articulates the value of the Medicaid program, reiterates Medicaid Directors’ commitment to targeted and effective reform of the program, notes the challenges with the financing reforms currently being debated, and calls for prioritizing the stabilization of the individual market before engaging in thoughtful and deliberative Medicaid reform.”
The statement characterizes Medicaid as a “successful, efficient, and cost-effective federal-state partnership” that “has a record of innovation and improvement of outcomes for the nation’s most vulnerable citizens.” While acknowledging that meaningful Medicaid reform has been a goal of Medicaid Directors, the statement also says that any changes “must be made thoughtfully and deliberately to ensure the continued provision of quality, cost-effective care.” 
The statement goes on to say that while NAMD members appreciate certain aspects of the BCRA,
“no amount of administrative or regulatory flexibility can compensate for the federal spending reductions that would occur as a result of this bill. Changes in the federal responsibility for financing the program must be accompanied by clearly articulated statutory changes to Medicaid to enable states to operate effectively under a cap. The Senate bill does not accomplish that. It would be a transfer of risk, responsibility, and cost to the states of historic proportions.”

The statement clarifies that while the Medicaid Directors do not have a consensus on per capita caps or block grants, the growth rates present in the BCRA are “insufficient and unworkable.” It ends by recommending that the stabilization of marketplace coverage be prioritized, with Medicaid reform undertaken at a time it can be approached in a thoughtful and deliberate way.