Medicaid directors: Graham-Cassidy would 'fail to deliver on goal of an improved healthcare system'

Alyssa Rege -

The National Association of Medicaid Directors issued a statement Sept. 21 voicing their concern the proposed Graham-Cassidy healthcare bill "would undermine [states'] efforts ... to deliver on [the nation's] collective goal of an improved healthcare system."

NAMD said the legislation, proposed by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., would restructure Medicaid funding into a  per-capita cap financing system. The directors claim "all states will be impacted by this change, regardless of their decisions to leverage the Medicaid expansion option under the ACA."

"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," NAMD noted.

The proposed legislation would also require states to create their own healthcare programs by 2020 — a feat, the organization said, would constitute a massive undertaking for states.

"The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated. 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," NAMD officials said. "The vast majority of states will not be able to do so within the two-year timeframe envisioned [in the bill], especially considering the apparent lack of federal funding in the bill to support these critical activities."

NAMD, which comprises Medicaid directors from each state, also said the Congressional Budget Office's inability to fully score the bill prior to the expected vote next week poses significant concern.

"A full CBO score … 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."

 

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