The American Health Care Act (AHCA) is not just an alarming, slapdash effort to repeal the Affordable Care Act—it’s also a plan to radically weaken Medicaid, our nation’s health care safety net. Indeed, the US House-passed bill’s most dramatic savings—$834 billion according to Congressional Budget Office estimates—are achieved by slashing federal funding to Medicaid, which provides health coverage to nearly 75 million low-income Americans, and undoing the program’s basic guarantee.
Nevertheless, these draconian reforms have been among the lesser told stories of the AHCA’s anticipated impact. The breakneck speed and secrecy surrounding the bill’s construction left little time to unpack how Medicaid per capita caps would affect the many populations, including older adults, people with disabilities, families, and children, who rely on Medicaid to afford quality health care. This includes the 11 million Americans—older adults and people with disabilities—who are enrolled in both Medicare and Medicaid. Of these millions of dually eligible beneficiaries, roughly 80 percent qualify for help paying for their Medicare coverage through the Medicare Savings Programs (MSPs). The US Senate is now repeating this exact process, meeting in secret and rushing to vote on a bill that will dismantle the Medicaid program.The above excerpt was originally published in Health Affairs Blog.