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  • Writer's pictureKaren McPhail, RN, MSN

Cassidy-Graham info for the day...

The Cassidy-Graham bill is proposed to reallocate health care funding now in place for the affordable care act and the expansion of medicaid and give funds to the states in the form of block grants.

What could happen as a result?

1. Congressional Budget Office (CBO) has generally estimated that 15 to 18 million fewer Americans would have health insurance in 2019.

2. Respected health-care consultant Avalere concluded that California would face a 13 percent shortfall ($78 billion between 2020 and 2026) under Cassidy-Graham compared to current law.

3. The bill has incentives for states to focus on income levels at 50 to 138 percent of the federal poverty line ($24,600 for a family of four), as block grant funding would be allocated according to the level of insurance coverage in that income range.

So what happens to the rest of us? As a result, states could then alter essential benefit rules to offer skimpy, low-premium plans for everyone else in the individual insurance market. Or some states may just take the federal money and use it to fund existing state health programs, which would do little to expand coverage. Hard to predict how stares will respond...

4. Caroline Pearson, senior vice president of Avalere, states, “Overall, we do believe that lower federal funding will reduce coverage nationally, but specific impacts will vary by state.” Lack of coverage estimates by the CBO or other health-care experts are concerning!

5. Manatt Health, a unit of a national law firm that advises states on health-care issues, stated that “the legislation could create significant fiscal and political pressure on state policymakers” as the federal funds were reduced over time.

6. Only 16 states would initially experience an increase in funding under the bill, according to the Avalere analysis, while over time a per capita cap in Medicaid funding would begin to compress, especially in the second decade after bill passage.

7. Drew Altman, President of the Kaiser Family Foundation, said in an email regarding the coverage levels “will quite literally depend on what each of the fifty states do (and don’t do) with the block grants they would receive.” He added: “I think it’s a very high bar to argue that federal funding to states will be cut by $160 billion (other estimates are higher) between 2020 and 2026."

Lot's to consider....

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