Medicaid Directors In The 50 States Oppose Trumpcare

Doctors, Hospitals, AARP, insurance companies, and a host of medical societies have all come out against the latest version of Trumpcare (the Graham-Cassidy bill) in the Senate. Now the NAMD, representing Medicaid directors in all 50 states, has joined in that opposition. Here is part of an article by Jessie Hellmann in The Hill:

The National Association of Medicaid Directors (NAMD) warned Republicans on Thursday that the Senate's latest ObamaCare repeal bill would place a massive burden on states.

The bill, sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), would eliminate ObamaCare's Medicaid expansion and subsidies beginning in 2020, converting the funding to state block grants.

It would also change the federal government's funding of the traditional Medicaid program from an open-ended commitment to the states to a per capita cap on each enrollee.

"Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history," the NAMD's board of directors wrote in a statement Thursday.

The NAMD, which is a coalition of Medicaid directors from every state, noted that while the proposal is intended to create maximum flexibility, it does not provide the statutory reforms necessary "commensurate with proposed funding reductions."

The GOP bill would also require states create their own health-care programs by 2020, which the directors argue is a massive undertaking.

"The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated," the directors said. 

"States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities. The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities."

The directors also hit Senate Republicans for not having a full Congressional Budget Office score before a possible vote on the bill, "which should be the bare minimum required for beginning consideration." 

"With only a few legislative days left for the entire process to conclude, there clearly is not sufficient time for policymakers, Governors, Medicaid Directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms," the directors said.