Medicaid changes in Better Care Reconciliation Act (BCRA) go beyond ACA repeal and replace
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Rudowitz, Robin, author Antonisse, Larisa, author Musumeci, MaryBeth, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, July 2017
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Care Reform -- legislation & jurisprudence Medicaid -- legislation & jurisprudence Capitation Fee Cost Sharing Medicaid -- economics Preexisting Condition Coverage Humans United States United States.
- Genre(s):
- Technical Report
- Abstract:
- The Senate released an updated discussion draft of legislation called the Better Care Reconciliation Act of 2017 (BCRA) on July 20, 2017. For Medicaid, the overall framework is very similar to earlier versions of the bill in the Senate as well as the American Health Care Act (AHCA) that passed in the House. Both the BCRA and the 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. The revised draft of the BCRA leaves many provisions up to HHS Secretary discretion, creating further uncertainty for states about how implementation of the legislation would proceed. 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. The Congressional Budget Office estimates that under current draft of the BCRA, federal Medicaid spending related to the coverage provisions would decline by $756 billion over the 2017-2026 period or $739 billion accounting for all Medicaid provisions in the bill. According to CBO's longer-term projections, the BCRA would reduce federal Medicaid spending by 35% in 2036 (Figure 1). These reductions would leave states with difficult choices about how to fill in the gaps in federal funding or cut back on Medicaid eligibility, benefits, or reimbursement rates (Figure 2). 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.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (6 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101717007 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101717007