Before the House narrowly approved the Republican bill to overhaul the Affordable Care Act, McCarthy defended it in an interview with CNN’s Dana Bash after she noted that Democrats paid a price at the polls for passing Obamacare. She wondered whether Republicans are “going to face that very same buzz saw for taking a benefit away.”
McCarthy responded, “We’re not taking a benefit away. Nobody on Medicaid is going to be taken away.”
Considering that the American Health Care Act would reduce anticipated Medicaid outlays by $880 billion, or 25 percent, over the next 10 years, what is he talking about?
Matt Sparks, a spokesman for McCarthy, offered this explanation: “There are no changes until 2020. Then states will continue to receive the enhanced federal match for current enrollees.”
McCarthy’s claim hinges on the phrase “current enrollees.” The Congressional Budget Office, in its evaluation of the first version of the AHCA, said the reduction in funding would result in 14 million fewer Medicaid enrollees by 2026, a decline of about 17 percent compared with current law. Much of the decline would stem from the proposal’s termination of the enhanced federal match for new enrollees in states that choose to expand Medicaid, as well as a new per-person cap on federal payments to states. A new, lower federal match rate would apply to new enrollees after Dec. 31, 2019.
The CBO anticipated that some states that had expanded Medicaid to people equal or below 138 percent of the poverty line would decide to no longer offer that coverage. Meanwhile, states that might have expanded coverage would decide not to do so.
In any case, current enrollees are grandfathered in, right? Well, the problem is that people cycle in and out of Medicaid all the time, as they change or lose jobs. The CBO concluded that the reduction in spending would increase quickly as the grandfathered enrollees cycle off the program and are replaced by new enrollees. Indeed, historical data cited by the CBO indicated that fewer than one-third of those enrolled as of Dec. 31, 2019, “would have maintained continuous eligibility two years later.”
You can read the rest at the Washington Post.