The ACA repeal and replace plan proposed by House Republicans Feb. 16 suggests significant cuts to the Medicaid program, leaving states to shoulder the majority of the costs, according to a report released by Fitch Ratings.
Here are four points the Fitch report outlined regarding the proposed plan.
1. The proposed plan calls for the repeal of the ACA's Medicaid expansion and enhanced federal match program, which 31 states are currently opted into. At the end of an unspecified amount of time, federal reimbursement to hospitals for patients insured through Medicaid expansion, currently at 95 percent, would drop to each state's standard federal match rate of approximately 50 percent to 75 percent.
2. Once enhanced federal funding for the Medicaid expansion program ends under the proposed plan, states participating in the expansion program would be faced with the choice of ending Medicaid coverage for the millions covered under the expansion or take on the costs previously shouldered by the federal government.
3. The plan also calls for repeal of the Medicaid Disproportionate Share funding cuts, a positive provision for hospitals that treat a large volume of Medicaid patients. Officials propose to implement the repeal as early as 2018.
4. The repeal and replace plan also proposes ending Medicaid's entitlement structure, giving the states the option of moving to a block grant system. Fitch analysts note the plan does not include a proposed timeline for the shift.
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