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This brief provides national and state-by-state estimates of the reductions in federal spending under the Better Care Reconciliation Act for the period 2020-2029 and for 2029 in order to see the full effect of policy changes over a ten-year period.
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 to impose work requirements, and make other eligibility changes. Across the board, these changes would have significant implications for the 74 million people covered by the Medicaid program and for states that jointly finance and administer the program. This brief explains the five most significant Medicaid changes in the BCRA as well as additional Medicaid changes that could have major implications for states, providers, and beneficiaries.
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.
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
The U.S. government is the largest donor to global health in the world. This fact sheet breaks down the U.S. global health budget by program area: HIV/PEPFAR; tuberculosis; malaria/the President's Malaria Initiative; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; maternal & child health; nutrition; family planning & reproductive health; global health security; and neglected tropical diseases.
Congress is currently debating the American Health Care Act (AHCA), which would repeal and replace the Affordable Care Act (ACA) and also make substantial changes to the structure and financing of Medicaid. Among other provisions, the AHCA would use a per capita cap policy to cap federal funds to states for Medicaid. This data note examines what the implications of tying per enrollee growth to CPI-M would have been for the 2001-2011 period for federal spending nationally and state-by-state by major enrollment group. This analysis is meant to illustrate how actual spending compares to spending limits that would have been in place if growth rates had been limited to CPI-M, similar to the limits proposed by the AHCA.
A new analysis from the Kaiser Family Foundation finds that the majority of states would have gotten less in federal Medicaid funding from 2001 to 2011 if Medicaid financing had been based on a per capita cap.
This slide and chart show state variation in Medicaid acute and long-term care spending, per enrollee, for FY 2011
The American Health Care Act recently passed by the House of Representatives includes a provision to ban federal Medicaid funding of Planned Parenthood. The Trump administration has also proposed reducing funding to HHS, which funds the Title X family planning program and community health centers.
This data note looks at Medicaid spending per full-benefit enrollee, examining variation by state and by eligibility group, as well as variation within a given state and eligibility group.
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