The Better Care Reconciliation Act (BCRA), the American Health Care Act (AHCA), and related proposals would fundamentally transform the Medicaid funding structure. Under these bills, states would no longer receive federal funds for a fixed percentage of state Medicaid costs. Instead, they would receive funding based on a capped per-capita formula, and could opt to receive block grants for non-disabled and non-elderly Medicaid populations. The per-capita funding caps would not account for unexpected nationwide or state-specific health care cost growth, and would leave states responsible for all Medicaid costs once the per-capita cap is reached.
To reduce federal spending, the bills set federal funding limits for Medicaid below current spending projections. In regards to the AHCA, the Congressional Budget Office (CBO) estimates that the plan would cut nearly $840 billion in funding from Medicaid over the next ten years, leaving states with a significant budget shortfall. Under current law, Medicaid spending already accounts for nearly 20 percent of state budgets – a figure that would increase significantly if states were responsible for bearing more of the cost of their Medicaid programs. In order to accommodate the loss of funding while still supporting mandatory Medicaid programs, states would likely limit eligibility and decrease benefits to enrollees. These forced cuts would reduce the quality of care for many people who depend on Medicaid to meet their health needs, making it more difficult for them to work, attend school, and live independently in their communities.
Throughout the summer and fall of 2017, the Epilepsy Foundation sent dozens of letters in opposition to proposals to "repeal and replace" the ACA that included provisions that would result in significant cuts to Medicaid.
Read these letters and follow our efforts at advocacy.epilespy.com/ACA.