What Does the Draft ACA Repeal/Replace Legislation Tell Us About the Future of Medicaid?
<p>Last week, draft legislation to repeal and replace parts of the Affordable Care Act (ACA) surfaced. In a new <em>To the Point</em> post, George Washington University's Sara Rosenbaum examines how the bill from from the U.S. House of Representatives approaches the ACA Medicaid expansion for working-age adults with low incomes, and how the Medicaid program—which serves 74 million adults and children—would function as a whole. </p><p>Rosenbaum explains that, under the draft bill, the ACA’s Medicaid expansion funding would cease at the end of 2019. The bill would also replace the current Medicaid funding system with "per capita cap" payments tied to enrollment. </p>
<p>"Per capita caps have a conceptual appeal, but making them work fairly and effectively would require multiyear pilots implemented in select states, not the sudden nationwide imposition of this complicated reconfiguration of the program," Rosenbaum says. "Medicaid is simply too important to the health care system, to state economies—and above all, to the people it serves—to be turned into a grand fiscal experiment on an unprecedented scale."</p>