Modern Healthcare interviewed Manatt’s Deborah Bachrach, a partner with Manatt Health, for an article on how the Senate Republican bill to repeal and replace the ACA would affect states’ Medicaid funding.
As reported by Modern Healthcare, the Better Care Reconciliation Act includes complex provisions to add funding to low Medicaid spenders and pull away dollars from higher-spending and expansion states, but it’s unclear whether the provisions will actually work as intended. Industry experts are concerned that the bill’s caps and adjustments would not give states enough financial flexibility to address emerging public health issues, new medical innovations and demographic changes.
"It's a very crude instrument for moving money from one state to another state," said Bachrach.
She warned that, under the Senate bill's payment adjustment formula, state officials would have to keep a close watch on Medicaid spending trends in other states, because they would be scored on a curve relative to those other states. And they would not know until the end of the fiscal year how they did. That might force states to cut benefits or provider payment rates in the middle of a budget year.
"It would cause states to manage to the cap rather than managing care," she said.