Dire Warning Issued to Republicans by Medicaid Directors - ProgressTribune.com
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Dire Warning Issued to Republicans by Medicaid Directors

The National Association of Medicaid Directors (NAMD) gave a warning to Republicans on Thursday that the Senate’s latest ObamaCare repeal bill would put a massive burden on states.

The bill, sponsored by Senators Lindsey Graham(R-S.C.) and Bill Cassidy (R-La.), would get rid of ObamaCare’s Medicaid expansion and subsidies starting in 2020, converting the funding to state block grants.

It would also alter the federal government’s funding of the traditional Medicaid program from an open-ended commitment given 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 warned in a statement Thursday.

The NAMD, which is a coalition of Medicaid directors from all 50 states, noted that while the proposal is intended to allow for maximum flexibility, it does not provide the statutory reforms needed “commensurate with proposed funding reductions.”

The GOP bill would also make states create their own health-care programs by 2020, which the directors claim 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 criticized Senate Republicans for not having a full Congressional Budget Office report 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.

Senate Majority Leader Mitch McConnell (R-Ky.) office has stated that the intention is to have a vote next week on the measure.

However, it’s not certain that Republicans have the 50 votes required for it to pass, with Vice President Pence casting a tie-breaking vote. Lawmakers are also being pressured to secure the votes, since the legislative vehicle Republicans are utilizing for the bill expires at the end of September.

The last GOP effort to ruin ObamaCare failed in July, when Sen. John McCain (R-Ariz.) cast the deciding vote against it.

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