Webinar — Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Following our June 5th webinar, “Per Capita Caps Under Medicaid: Emerging Issues for States,” State Network, in partnership with technical experts from Manatt Health, is hosting a series of conversations that will provide opportunities for state leadership to dive deeper into emerging issues. Given the recent release of the Senate repeal and replace proposal, we will review and discuss the Senate’s BCRA. State Network, in partnership with technical experts from Manatt Health, will host a webinar during which we will review the major Medicaid provisions of the BCRA, providing an opportunity for state leadership to understand how the Senate bill compares to the AHCA and its potential implications for states. This session will start with a short presentation, followed by time for Q&A and a discussion, focusing on the Medicaid provisions of the BCRA.
Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Senate leadership has released a proposed substitute for the House-passed American Health Care Act (AHCA) known as the Better Care Reconciliation Act of 2017 (BCRA) that eliminates enhanced funding for Medicaid expansion after a three-year phase out, establishes a cap on federal Medicaid funding for nearly all beneficiaries and services, and makes a number of other changes to Medicaid. Using the Manatt Medicaid Financing Model, this analysis estimates the state-by-state impact of the cap on Medicaid and elimination of enhanced funding for expansion, taking into account that states may respond to the proposed law in a number of different ways.
The American Health Care Act (AHCA), as passed by the House of Representatives on May 4, 2016, would overhaul federal financing of state Medicaid programs, and for the first time, would cap federal Medicaid funding. As policymakers debate the potential implications of per capita caps, it has been suggested that per capita caps are really no different than Medicaid managed care—a concept with which states are fully familiar and well able to manage. This policy brief tests that hypothesis by examining the similarities and differences between the federal per capita cap and a state’s per capita “cap” in Medicaid managed care spending.
Following the House’s passage of the American Health Care Act (AHCA) and the Senate’s on-going repeal and replace negotiations, it is clear that significant changes to federal Medicaid financing remain in play. Building on past State Network webinars that have reviewed the AHCA Medicaid financing provisions and identified their implications for states, the State Network, in partnership with technical experts from Manatt Health, held a webinar that provided a deep-dive on critical issues that will influence the impact of capped funding on states, including choice of base year, trend rates, and treatment of supplemental payments. The discussion was informed by updated modeling based on the House-passed version of the AHCA.
Medicaid’s unique and critical role in responding to events such as the opioid and HIV/AIDS epidemics, the 2001 World Trade Center attacks, the Flint, Michigan lead contamination crisis, and Hurricane Katrina are discussed in this brief.
Health Savings Accounts have been a frequent topic of conversation for policy options in the ACA markets. HSAs have gained attention in recent years as they are featured in both “Repeal & Replace” and Medicaid proposals. This webinar reviewed the basics of HSAs, how they have been considered under various repeal and replace proposals, and how alternative Medicaid expansions have used HSA-like programs for enrollees.
Continued uncertainty surrounding federal legislative action affecting the Affordable Care Act (ACA) have led many states to reconsider the option of Section 1332 State Innovation Waivers. These waivers allow states broad flexibility to redesign the coverage provisions of the ACA according to certain statutory guidelines. Given the renewed interest in 1332 waivers, the State Network hosted a webinar for state officials featuring the experts at Manatt Health.
As states seek to understand the impacts of proposed changes to Medicaid financing, comparative data on where states stand can be very valuable. The memos included here use state-specific data to analyze the impact of proposals to limit federal Medicaid funding on all 50 states and the District of Columbia.
American Indians and Alaska Natives could face a disproportionate impact in the event of ACA repeal. This report, authored by Dr. Donald Warne at North Dakota State University, in partnership with the National Indian Health Board, highlights the specific effects of ACA repeal.
Changes to the individual health insurance market are at the heart of the American Health Care Act. This webinar featured experts from Manatt Health who discussed changes in the individual market, including tax credits and the marketplace, that states will need to consider moving forward. The attached slide deck includes details on what is in the legislation, what are the key policy areas for states and an impact analysis for state policy makers.