PROVIDENCE, R.I. (WPRI) – Senate Republicans’ latest proposal to repeal and replace the Affordable Care Act would reduce Rhode Island’s federal health-care funding by $20 billion over the next decade and a half compared with current policy, according to a new study by consulting firm Avalere Health.
The bill, sponsored by Sens. Lindsey Graham and Bill Cassidy, would repeal the health law’s Medicaid expansion as well as its subsidies for individuals to buy insurance, switch instead to block grants for states. The bill would also cap funding to states for traditional Medicaid enrollees rather than pay those costs on an open-ended basis.
“The Graham-Cassidy bill would significantly reduce funding to states over the long term, particularly for states that have already expanded Medicaid,” Caroline Pearson, a senior vice president at Avalere, said in a statement. “States would have broad flexibility to shape their markets but would have less funding to subsidize coverage for low- and middle-income individuals.”
The Avalere study found the various changes would reduce federal funding to states by $4.15 trillion from 2020 to 2036 compared with current law. Rhode Island’s funding would be $2 billion, or 13% lower, through 2026; $3 billion, or 18% lower, through 2027; and $20 billion, or 39% lower, through 2036.
“The largest impact of the proposed bill would be the reallocation of federal dollars between states,” Elizabeth Carpenter, another senior vice president at Avalere. “Medicaid expansion states and states that have enrolled a high number of people in insurance affordability programs would be most adversely impacted.”
Rhode Island is among the states that expanded Medicaid eligibility in 2014 under the Affordable Care Act, partly to take advantage of generous federal reimbursement policies. The state spent $2.4 billion on Medicaid in the 2015-16 fiscal year, making it the largest single program in the state budget.
The new study was funded by the Center for American Progress, a liberal think tank, but Avalere said it “maintained full editorial control” over the findings. Rhode Island’s Democratic elected leaders have uniformly opposed Republican efforts to repeal President Obama’s health law.
Senate Republicans have said they are considering holding a vote on the Graham-Cassidy bill by Sept. 30, after which a technicality in the chamber’s rules will remove their ability to pass a health overhaul with only 51 votes. Graham, R-South Carolina, has insisted this is the best chance for Republicans to repeal and replace the health law.
“Our bill levels out an inequity in funding,” Graham said earlier this month. “It allows flexibility that Obamacare would never embrace. It gives patients a voice in health care [that] they’ll never have through a single-payer health care system.”
“If you believe repealing and replacing Obamacare is a good idea, this is your best and only chance to make it happen because everything else has failed,” Graham added.
Vice-President Mike Pence tweeted Wednesday that he and President Trump “fully support” the Graham-Cassidy legislation. “Let’s get this done,” he wrote.Ted Nesi (firstname.lastname@example.org) covers politics and the economy for WPRI.com. He writes Nesi’s Notes on Saturdays and hosts Executive Suite. Follow him on Twitter and Facebook