Impacts of New Graham-Cassidy Repeal and Replace Proposal

Prepared for the Robert Wood Johnson Foundation

On September 13, 2017, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA)—along with Senators Dean Heller (R-NV) and Ron Johnson (R-WI) and former Senator Rick Santorum (R-PA)—released a new proposal to “repeal and replace” the Affordable Care Act (ACA) . The new proposal is an updated version of the proposal that Senators Graham and Cassidy filed on July 27.

Over the 2020 to 2026 period, the block grant would provide 6.4 percent less federal funding than under current law.

The Graham-Cassidy ACA repeal and replace legislation would retain many features of the Better Care Reconciliation Act (BCRA) voted down by the Senate on July 25, including per capita caps on Medicaid spending and elimination of the individual and employer mandates. However, it also goes beyond that proposal by converting Marketplace and Medicaid expansion federal funding into a block grant. Over the 2020 to 2026 period, the block grant would provide 6.4 percent less federal funding than under current law. The size of the gap between current law funding and the block grant appropriation would be 8.9 percent by 2026.

In a new issue brief for the Robert Wood Johnson Foundation State Health & Value Strategies project—State Policy and Budget Impacts of New Graham-Cassidy Repeal and Replace Proposal—Manatt Health provides a detailed overview of the new proposal, including key details on the proposed block grant, referred to as the “Market-Based Health Care Grant Program.” To read the full issue brief, click here.