As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
The brief provides an overview of the most recent changes to the Graham-Cassidy repeal and replace proposal and a just-released preliminary analysis of the proposal by the Congressional Budget Office (CBO). On September 13th, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA)—along with Senators Dean Heller (R-NV) and Ron Johnson (R-WI) and former Senator Rick Santorum (R-PA)—released a new proposal to repeal and replace the Affordable Care Act (ACA). On September 25th, the sponsors released several updates to the proposed legislation. Also on September 25th, the CBO provided its preliminary analysis of one of the earlier versions of the bill.
In a final effort to pass a bill to repeal and replace the Affordable Care Act before reconciliation instructions expire on September 30th, Senators Graham and Cassidy are advancing a proposal that would retain many key provisions of the Better Care Reconciliation Act (BCRA) – including per capita caps for Medicaid non-expansion populations – and replace federal funding for tax credits, cost sharing reductions, Medicaid expansion, and the Basic Health Program with a capped allotment that would be distributed to states in the form of a block grant.