Medicaid has become the Republican's primary target for massive budget cuts in the health sector. Which makes a new study from Kaiser Family Foundation and Urban Institute on the Republican budget, which would turn Medicaid into a block grant program and repeal the Affordable Care Act, even more critical. KFF and the Urban Institute find that the Republican budget could create an additional 44 million uninsured over the next ten years.
From KFF's press release announcing the study:
Under the House Budget Plan, advanced by House Budget Committee Chairman Paul Ryan, projected federal spending on Medicaid for the period 2012 to 2021 would fall by $1.4 trillion, a 34 percent decline. In 2021, the end of the typical 10-year budget window used by Congress, states would receive $243 billion less annually in federal Medicaid funding than they would under current law, a 44 percent reduction, as shown in Figure 1. The plan’s two-pronged approach would curb Medicaid spending and enrollment by eliminating the Patient Protection and Affordable Care Act (ACA) and its major Medicaid expansion scheduled to begin in 2014, and by capping the amount of federal funding for Medicaid through a block grant.
According to the new analysis of the plan conducted by researchers at the Urban Institute working with analysts at the Foundation, total federal Medicaid spending reductions over the next decade relative to current law would range from a 26 percent drop in Washington, Vermont and Minnesota, to 41 percent declines Oregon, Georgia and Colorado and a 44 percent decrease in Florida. The analysis also finds that hospitals could see their Medicaid payments fall by as much as 38 percent, relative to current projections, in 2021.
"Under the House Budget Plan, the Medicaid block grant would reduce and cap federal Medicaid spending, substantially reducing states’ ability to provide coverage to low-income Americans," said Diane Rowland, Executive Vice President of the Foundation and Executive Director of the Kaiser Commission on Medicaid and the Uninsured. "The repeal of the ACA combined with the adoption of the Medicaid block grant would add millions more to the number of uninsured Americans and compromise Medicaid’s role as the health safety net in the next recession."
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Because Medicaid is financed jointly by the states and the federal government, the impact of the House Budget Plan on program enrollment would depend in part on the spending and policy choices that states make in the face of diminished federal funding. The analysis examines three possible scenarios for state responses to the block grant which would produce decreases in Medicaid enrollment relative to current projections ranging from 31 million people to 44 million people nationally, as shown in Figure 2. Between 14 million and 27 million low income people would lose coverage due to the implementation of the block grant alone, the analysis finds.
Additionally, "hospitals could see reductions in Medicaid funding of between 31 percent and 38 percent annually, or as much as $84.3 billion." Which means, of course, reduced access to people who have likely already lost coverage.
Much of the focus of the disastrous Republican budget plan has been on Medicare, but the cuts to Medicaid would be as drastic and as disastrous, creating a double-whammy for the nation's seniors (because of the large component of Medicaid that provides long-term care for the elderly) but also for millions of working families. There's no tort reform or interstate purchase of health insurance plans in the world that could reduce the costs having so many more uninsured Americans would create for the system.