ADvancing States has submitted a letter to Senate leadership regarding the Graham-Cassidy ACA repeal legislation. In our bill analysis, this legislation includes a number of changes to the core Medicaid program in addition to the repeal of ACA coverage expansions and creation of state healthcare block grants.  Our comments largely focus on the Medicaid changes, which include:

• Concerns regarding unintended consequences of implementing per capita caps in Medicaid;
• Challenges associated with the lack of state flexibility accompanying the funding cuts; 
• Requesting that Congress promote HCBS rebalancing by retaining the 1915(k) increased FMAP;
• Questions regarding the operationalization of the HCBS provider payment adjustment grants; and
• Encouraging Congress to adequately fund any replacement to ACA coverage expansions.

The letter is similar to comments we submitted on prior ACA repeal-replace proposals, largely because the per capita cap policy is quite similar in this bill.

Click here to read the letter.