The Better Care Reconciliation Act released by Majority Leader Mitch McConnell significantly cuts Medicaid services for people with disabilities:
The Better Care Reconciliation Act ends the Community First Choice Program, which will directly cut funding currently used to provide Medicaid services for people with disabilities.
The Better Care Reconciliation Act ends the federal government commitment to match a state’s actual costs to care for and provide support for people with disabilities who are enrolled in Medicaid.
The Better Care Reconciliation Act replaces this federal matching guarantee with a lump sum, based on a per capita cap formula using past costs times the number of individuals with disabilities enrolled in the state Medicaid program.
The capped federal lump amount does not increase if an individual’s cost of care goes up—due to deteriorating health or changes in a chronic condition.
The capped federal lump amount does not increase if a new, promising—but more costly—drug treatment is discovered to better address a disease or chronic condition.
A capped funding structure uses a one-size-fits-all approach to financing health care. It does not account for changes to a person’s health or disability.
This massive Medicaid cost-shift to states will, according to the Congressional Budget Office, force states to:
The annual Medicaid growth rate adjustments in the Better Care Reconciliation Act fail to keep up with actual costs to provide Medicaid care and services for individuals with disabilities.
The annual adjustments are not based on individual need or even state cost to provide care and supports for individuals with disabilities.
Rather, the Better Care Reconciliation Act uses two formulas—both of which severely undercut the true, annual cost of delivering health care and community supports for people with disabilities. The Senate bill’s failure to meet Medicaid’s actual growth rates will result in real state funding cuts for disability services.
Under current Medicaid law, the federal government reimburses based on the full cost (ie: $105) rather than a capped adjustment (ie: $103.70), as proposed in the Senate bill.
States will be forced to add new resources or—more likely—cut, restrict or eliminate Medicaid services in order to make up for the difference between true health care costs and the federal reimbursement adjustment.
Easterseals urges the U.S. Senate to oppose the Better Care Reconciliation Act for its real cuts to Medicaid services for children and adults with disabilities.
Medicaid is already underfunded, which has resulted in cuts to essential services and longer wait lists for children and adults with disabilities.
The Senate health care bill will accelerate this problem by instituting restrictive caps on federal Medicaid funding.
The legislation fails to meet Easterseals’ basic do-no-harm standard for health care reform.