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The Graham-Cassidy proposal to repeal and replace the Affordable Care Act (ACA) is reviving the federal health reform debate and could come up for a vote in the Senate before the budget reconciliation authority expires on September 30. This fact sheet describes five ways in which the proposal revamps and cuts Medicaid, redistributes federal funds across states and eliminates coverage for millions of poor Americans.
On September 7, 2017, the Senate Committee on Appropriations approved both the FY 2018 State & Foreign Operations (SFOPs) and the FY 2018 Labor, Health & Human Services (LHHS) appropriations bills. The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID), while the LHHS appropriations bill includes funding for global health programs at the Centers for Disease Control and Prevention (CDC) and the…
In a Health Affairs blog post, Joshua M. Wiener and Melissa Romaire of RTI International and MaryBeth Musumeci of the Kaiser Family Foundation examine whether states could successfully cope with substantial reductions in federal Medicaid funding under a per capita cap or block grant system by improving efficiency in the way both acute and long-term care are delivered and paid for under the program. A review of the evidence in literature suggests that large Medicaid…
In a Health Affairs blog post, Jen Kates and Adam Wexler of the Kaiser Family Foundation and Nafis Sadat and Joseph Dieleman of the Institute for Health Metrics and Evaluation assess what cuts to U.S. global health funding as proposed in the Trump Administration FY 2018 budget request might mean in the larger context of development assistance for health.
This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA's Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.
The Better Care Reconciliation Act (BCRA) under consideration in Congress includes provisions that would fundamentally change Medicaid by phasing out extra federal funding for states’ Medicaid expansions and for the first time limiting federal spending on Medicaid through a per enrollee cap on financing or a block grant for certain adults. While those measures account for most of the bill’s $756 billion reduction in federal Medicaid spending over the next decade, there are other big…
Both the Senate's Better Care Reconciliation Act of 2017 (BCRA) and the House's American Health Care Act (AHCA) go beyond repeal and replacement of the Affordable Care Act (ACA) to make fundamental changes to Medicaid by setting a limit on federal funding through a per capita cap or block grant. The BCRA also includes additional changes that would further reduce federal spending for states with high per enrollee spending, limit state financing mechanisms, allow states…
President Trump’s fiscal year 2018 budget request would cut global health programs by approximately $2.5 billion. This analysis models the potential impact of the Administration’s proposed budget, as well as two budget scenarios with more modest decreases.
Donor government funding to support HIV efforts in low- and middle-income countries decreased by US$511 million from US$7.5 billion in 2015 to US$7 billion in 2016, finds a new report from the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS). This marks the second successive year of declines, and is the lowest level since 2010. The decrease stems from actual cuts in funding (accounting for an approximate net 50% of the decline),…
This report provides an analysis of donor government funding to address the HIV response in low- and middle-income countries in 2016, the latest year available, as well as trends over time. It includes both bilateral funding from donors and their multilateral contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), UNITAID, and Joint United Nations Programme on HIV/AIDS (UNAIDS).
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