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Data Note: What if Per Enrollee Medicaid Spending Growth Had Been Limited to CPI-M from 2001-2011?

Congress is currently debating the American Health Care Act (AHCA), which would repeal and replace the Affordable Care Act (ACA) and also make substantial changes to the structure and financing of Medicaid. Among other provisions, the AHCA would use a per capita cap policy to cap federal funds to states for Medicaid. This data note examines what the implications of tying per enrollee growth to CPI-M would have been for the 2001-2011 period for federal spending nationally and state-by-state by major enrollment group. This analysis is meant to illustrate how actual spending compares to spending limits that would have been in place if growth rates had been limited to CPI-M, similar to the limits proposed by the AHCA.

Restructuring Medicaid in the American Health Care Act: Five Key Considerations

On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected under current law, and 14 million fewer people would be covered by Medicaid than expected under current law. This brief considers five key Medicaid implications of the House bill.

What Are the Implications for Medicare of the American Health Care Act?

This issue brief highlights a major implication of the American Health Care Act for Medicare. The AHCA repeals the Affordable Care Act provision to increase the payroll tax on high-income earners. Repealing this surtax would move up the insolvency date of the Medicare Part A trust fund by 3 years from 2028 to 2025, and also worsens the program’s long-term financial outlook.

Medicaid’s Role: What’s at Stake Under a Block Grant or Per Capita Cap?

This video provides an overview of the people covered by Medicaid and how Medicaid funds are distributed across enrollment groups and on a per enrollee basis. The video also highlights the implications of reducing federal Medicaid funds through a block grant or per capita cap.

Data Note: Variation in Per Enrollee Medicaid Spending Across States

Proposals to transition Medicaid a block grant or per capita cap would reduce federal spending. To understand per capita cap proposals, it is helpful to understand variation in per enrollee spending and per enrollee spending growth across states and enrollment groups. A per capita cap policy could lock in historic variation. This data note uses interactive maps and tables to show variation in per enrollee spending and spending growth by state and eligibility group.

3 Key Questions: Section 1115 Medicaid Demonstration Waivers

Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states considerable flexibility in how they operate their programs, beyond what is available under current law, and can have a significant impact on program financing. This brief answers key questions about Section 1115 waiver authority, the current landscape of demonstration waivers and what to watch going forward.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.