If you didn’t read this great round-up of how the House AHCA and the Senate BCRA would increase the uninsured, cut Medicaid, and affect Texas, go take a look now. With the July 4th holiday, you may have missed a couple of updates adding to the growing body of evidence of deep harm to our most vulnerable Texans and to hard-working families threatened by both of these bills.
Because the Senate bill included an old legislative trick—delaying a big Medicaid cut to the end of the decade to camouflage its impact—members of the Senate Budget and Finance committees requested a supplemental CBO report on the long-term effects (i.e., the impact over the second decade of the proposed law) of the Senate health care bill’s Medicaid growth cap. The CBO published that analysis last week (6/29), and that report shows that while national Medicaid spending would be cut to 26 percent lower in 2026 than it would be under current law, the deeper cuts cause the reduction to the Medicaid to grow to 35 percent in 2036.
The next day (6/30), some new estimates of the 50-state impact of the Senate bill were released by Manatt Health, for the Robert Wood Johnson Foundation. The authors report that the 19 non-Medicaid expansion states are still slated to lose $53 billion from 2020 to 2026 in federal Medicaid dollars because of the per capita cap that launches in 2020. Cuts to the existing (pre-ACA expansion) Medicaid program will hit people with disabilities the hardest, with seniors, children, and pregnant women following behind.
The analysts predict Texas would lose $10.5 billion in federal Medicaid dollars for our current (unexpanded) Medicaid program between 2020 and 2026. That’s about $1.5 billion a year.
Of this loss, $4 billion would be for care for Texans with disabilities, $2 billion for seniors, $3.4 billion for children, and $1 billion for pregnant women and the small number of parents who qualify for Texas Medicaid.
Our Texas Legislature recently opted not to invest $75 million a year to reverse damaging cuts to pediatric Medicaid payments for speech, physical, and occupational therapy. A loss of federal Medicaid funds of $1.5 billion a year is unlikely to be replaced by our current leadership, and the injury will be borne by our most vulnerable Texans.