Study: ACA repeal guts federal health spending
New analysis looks at deep cuts in latest health bill.
The Cassidy-Graham bill would slash $180 billion to states that expanded Medicaid, analysis says.
A new analysis released Thursday buttresses a growing body of evidence that the Senate’s Cassidy-Graham health care bill would slash federal spending on health coverage and cause most states to lose billions of dollars in such aid.
According to the report by the Kaiser Family Foundation, the Republican plan to dismantle much of the Affordable Care Act would cut federal spending on health insurance by an average of 11 percent between 2020 and 2026 in the 31 states, plus the District of Columbia, that have expanded their Medicaid programs under the law. The states that have not expanded Medicaid — all but one led by Republicans — would gain an average of 12 percent during that period.
As a result, states that kept their Medicaid programs small would receive an extra $73 billion, while the federal money to the Medic- aid expansion states would be cut a total of $180 billion.
Overall, the analysis by Kaiser, a leading health policy organization, predicts a slightly smaller decrease than other assessments of govern- ment spending. The pending bill — which is known by the names of its primary sponsors, Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina — would abolish key aspects of the ACA, replacing most of the law’s rules with block grants to states and ending the way Medicaid has worked for more than a half-century.
Using a different method of calculating the legislation’s effects, Kaiser forecasts an overall reduction of $160 billion between 2020, when most of the bill’s changes would begin, and 2026, when it would stop funding the block grants. That compares with $215 billion less in federal spending predicted in an analysis this week by Avalere Health, a consulting firm, and $243 billion in a report by a liberal think tank, the Center on Budget and Policy Priorities.
All three analyses show that, no matter whether Congress renews spending for the block grants after 2026, federal aid for Medicaid would plummet across the country because the program’s enti- tlement funding would be replaced with a per-person cap. And over time, annual increases under that new method would tighten.
Such independent assess- ments are significant as the bill hurtles toward an expected vote next week, so quickly that the Congressional Budget Office is still working on even a rudimen- tary official forecast.
Some worried states — including those with sena- tors whose support for the Cassidy-Graham plan will be crucial for its passage — are doing their own assessments of the legislation’s impact.
Alaska’s conclusions, in particular, will be significant politically because its governor, Bill Walker, an independent, is one of 10 who signed a letter this week opposing the bill, and Alaska Sen. Lisa Murkowski, a Republican, is widely considered a key swing vote on the measure.
In Colorado, an analysis already indicates that it would lose more than $1 billion annually in federal fund- ing by 2025. In 2027, when the block grant money ends, this amount would increase to nearly $3 billion annually.