Key Republicans Tout Report Outlining Considerations of Per Capita Caps for Medicaid
September 12, 2016 02:35 PM
Senate Finance Committee Chairman Orrin Hatch (R-UT) and House Energy and Commerce Committee Chairman Fred Upton (R-MI)on Friday touted a new Government Accountability Office (GAO) report detailing possible per capita Medicaid caps.
The report, requested by both chairmen, outlines how the design of Medicaid per capita caps should function if the change was adopted. Coverage, flexibility, allocation of funds across states over time, accountability and other broader effects of implementing per capita caps for Medicaid were discussed in the report.
In response to the release of the report, both Hatch and Upton released statements praising the report and expressing concern about the growth in Medicaid spending.
“With Medicaid growing at an unprecedented rate, Congress will be forced to look for ways to reform the program as we look toward the future in order to uphold care for our nation’s vulnerable families,” Hatch said. “On the financing front, a per capita approach is a worthy option that could, when paired with other program reforms, set Medicaid on a fiscally responsible course while protecting beneficiaries from harsh, across the board cuts in the future. The GAO’s work on this issue provides us with the information we need to explore this idea in greater detail as we continue the conversation on how to best finance the Medicaid program in our changing world.”
“Medicaid is a critical program that continues to be relied upon by our nation’s most vulnerable folks,” said Upton. “About 20 years ago, then-President Clinton proposed reforming Medicaid’s financing with a per capita cap. Today’s program is about three times larger than it was in 1997, and the program’s outlays are set to roughly double over the coming decade. In order to ensure it meets the demands of those it currently serves, and those it will serve in the future, it is imperative we examine ways to improve the incentives and flexibilities in the program, while protecting the care of the people Medicaid serves. This carefully researched report gives lawmakers useful considerations for further discussions about policies that could strengthen Medicaid for the most vulnerable.”
Both Hatch and Upton are no strangers to per capita caps for Medicaid. Both men authored “Making Medicaid Work,” a 2013 proposal to implement a per capita allotment and their Patient CARE Act contains a form of per capita spending allotment for Medicaid.
In its 2016 Legislative Blueprint for Action, NAHC opposed per capita caps. “Congress should reject any consideration of placing caps on Medicaid spending and increase the federal match for state Medicaid programs, thereby bolstering efforts to bring states into compliance with the Olmstead decision. Proposals for per beneficiary caps or full program federal spending caps such as block grants should be rejected by Congress.”
A recent analysis by the Center on Budget and Policy Priorities similarly stated that “a per capita cap would shift large costs to states and almost certainly lead over time to substantial cuts affecting low-income beneficiaries and health care providers. It also would likely discourage states from taking up health reform’s Medicaid expansion and could cause some states to abandon the expansion.”
NAHC Report will continue to provide updates regarding future legislative efforts on Medicaid relevant to the home care and hospice community.