Status Quo Healthcare 50 – Graham-Cassidy Zero
by Stephen Lendman (stephenlendman.org – Home – Stephen Lendman)
That’s the verdict of Medicaid directors in all 50 states – joining other health, medical and patient advocacy groups, opposing the deplorable Graham-Cassidy Obamacare replacement bill, its provisions discussed in an earlier article.
The National Association of Medicaid Directors (NAMD) blasted Graham-Cassidy, calling it “the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history.”
Establishing healthcare plans in all 50 states would require enormous effort, resources and time, creating an unacceptable patchwork, coverage varying by states nationwide, most unable or unwilling to craft acceptable plans, especially without considerable federal funding not forthcoming, leaving America’s most vulnerable without vital coverage or enough of it in case of serious illnesses, diseases or injuries.
Former Centers for Medicare and Medicaid Services administrator Andy Slavitt called unanimity by 50 Medicaid directors “very unusual.”
The NAMD statement on Graham-Cassidy was as follows:
“The Board of Directors of the National Association of Medicaid Directors (NAMD) urges Congress to carefully consider the significant challenges posed by the Graham-Cassidy legislation.
State Medicaid Directors are strong proponents of state innovation in the drive towards health care system transformation.
Our members are committed to ensuring that the programs we operate improve health outcomes while also being fiscally responsible to state and federal taxpayers.
In order to succeed, however, these efforts must be undertaken in a thoughtful, deliberative, and responsible way.
We are concerned that this legislation would undermine these efforts in many states and fail to deliver on our collective goal of an improved health care system.
1. Graham-Cassidy would completely restructure the Medicaid program’s financing, which by itself is three percent of the nation’s Gross Domestic Product and 25 percent of the average state budget.
Like BCRA, the legislation would convert the traditional Medicaid program into a per-capita cap financing system. All states will be impacted by this change, regardless of their decisions to leverage the Medicaid expansion option under the ACA.
It would also incorporate Medicaid expansion funding and other ACA health funds into a block grant, made available to all states.
How these block grants will be utilized, what programs they may fund, and the overall impact they will have on state budgets, operations, and citizens are all uncertain.
Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history.
While the block grant portion is intended to create maximum flexibility, the legislation does not provide clear and powerful statutory reforms within the underlying Medicaid program commensurate with proposed funding reductions of the per capita cap.
2. The Graham-Cassidy legislation would require states to operationalize the block grant component by January 1, 2020.
The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated.
States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities.
The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities.”
Separately, and most important, Sen. John McCain said he’ll vote “no” on Graham-Cassidy. Rand Paul expressed strong opposition earlier. Susan Collins leans “no.” Lisa Murkowski is undecided, another possible “no.”
Three GOP “no” votes kill the measure, not certain but likely.
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