Late today, or within a few hours after this interview was completed, the House Republicans proposed ACA repeal or reconciliation legislation. The legislation includes repealing Medicaid expansion under the Affordable Care Act (ACA). More specifically, House Republicans propose repealing the federal enhanced match rate for eligible beneficiaries on December 31, 2019 though states can keep the enhanced match rate for those Medicaid eligible before January 1, 2020 but only for those that do not have a break in Medicaid eligibility for more than one month after that January 1, 2020.. Moreover, the proposed legislation would reform federal Medicaid funding by creating a per capita cap model starting in 2020. This means federal funding would be benchmarked to 2016 for the five Medicaid enrollee categories: the elderly; blind and disabled; children; non-expansion adults; and, expansion adults. Year- over-year federal spending increases would be pegged to the medical care component of the Consumer Price Index (CPI). While there is not yet a Congressional Budget Office (CBO) score for the proposed legislation, that's schedule for mark up on Wednesday, estimates by the Center for Budget and Policy Priorities (CBPP) project that if the 32 states that expanded Medicaid coverage under the ACA wanted to keep it, the cost to these states would be approximately $280 billion over the next decade. CBPP also estimates that per capita caps will increase the state's share of Medicaid costs, excluding expanded coverage, by another $280 billion also over 10 year budget window.
During this 25-minute interview, Executive Director of the National Association of Medicaid Directors (NAMD), Matt Salo, discusses the mission of NAMD, his understanding of House Republican legislation to fundamentally reform the Medicaid program, the challenges with either Medicaid block grants or per capita caps, and other related policy issues the NAMD is working to resolve.
Mr. Matt Salo has served as Executive Director of NAMD since 2011. NAMD is a non-partisan association representing all 56 of the nation's state and territorial Medicaid Directors. Prior to NAMD, Mr. Salo spend 12 years at the National Governors Association where he worked to forward the Association's health and human services policy agenda. Prior still Mr. Salo worked for five years as a health policy analyst at the American Public Human Services Association. Mr. Salo also spent two years as a substitute teacher in the Alexandria, VA public school system. Mr. Salo holds a BA in Eastern Religious Studies from the University of Virginia.
For more on the NAMD go to: http://medicaiddirectors.org/
For more on House ACA repeal or reconciliation legislation go to:
https://energycommerce.house.gov/hearings-and-votes/markups/markup-committee-print-and-h-res-154
Proposed House Republican Changes to Medicaid: A Conversation with Matt Salo (March 6th)