Medicaid directors issue warning on new ObamaCare repeal bill

The National Association of Medicaid Directors (NAMD) warned Republicans on Thursday that the Senate's latest ObamaCare repeal bill would place a massive burden on states.

The bill, sponsored by Sens. Lindsey GrahamLindsey Olin GrahamTrump says he'll '100 percent' veto measure blocking emergency declaration Overnight Defense: Dems tee up Tuesday vote against Trump's emergency declaration | GOP expects few defections | Trump doubles number of troops staying in Syria to 400 On The Money: Dems set Tuesday vote on Trump's emergency declaration | Most Republicans expected to back Trump | Senate plots to avoid fall shutdown drama | Powell heading before Congress MORE (R-S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyCongress must step up to protect Medicare home health care Ivanka Trump to meet with GOP senators to discuss paid family leave legislation Bipartisan senators ask industry for information on surprise medical bills MORE (R-La.), would eliminate ObamaCare's Medicaid expansion and subsidies beginning in 2020, converting the funding to state block grants.

It would also change the federal government's funding of the traditional Medicaid program from an open-ended commitment to the states to a per capita cap on each enrollee.

"Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history," the NAMD's board of directors wrote in a statement Thursday.

ADVERTISEMENT

The NAMD, which is a coalition of Medicaid directors from every state, noted that while the proposal is intended to create maximum flexibility, it does not provide the statutory reforms necessary "commensurate with proposed funding reductions."

The GOP bill would also require states create their own health-care programs by 2020, which the directors argue is a massive undertaking.

"The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated," the directors said. 

"States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities. The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities."

The directors also hit Senate Republicans for not having a full Congressional Budget Office score before a possible vote on the bill, "which should be the bare minimum required for beginning consideration." 

"With only a few legislative days left for the entire process to conclude, there clearly is not sufficient time for policymakers, Governors, Medicaid Directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms," the directors said. 

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellKids confront Feinstein over Green New Deal Trump selects Kelly Craft for United Nations ambassador Union leader says Green New Deal would make infrastructure bill ‘absolutely impossible’ MORE's (R-Ky.) office has said the intention is to have a vote next week on the measure. 

However, it's unclear if Republicans have the 50 votes needed for it to pass, with Vice President Pence casting a tie-breaking vote. Lawmakers are also under pressure to secure the votes, since the legislative vehicle Republicans are using for the bill expires at the end of September.

The last GOP effort to repeal ObamaCare failed in July, when Sen. John McCainJohn Sidney McCainGabbard hits back at Meghan McCain after fight over Assad Mellman: Where are good faith and integrity? GOP senator says Republicans didn't control Senate when they held majority MORE (R-Ariz.) cast the deciding vote against it.