ACA replacement plan could cost states billions, leave millions uninsured: 3 things to know

Governors received an analysis last weekend highlighting how changes to the ACA could affect their states, The Washington Post reports.

The 36-page analysis, which The Washington Post obtained a copy of, was prepared for the National Governors Association's annual winter meeting by Avalere Health, a healthcare consulting firm.  

Here are three takeaways from the document.

1. The analysis shows repealing and replacing the ACA could prove costly for states, which stand to lose billions over five years under a Republican leadership plan, according to the report. The analysis notes an ACA replacement could also lead to a significant increase in the number of uninsured people, according to the report.

2. Republicans have floated the idea of repealing Medicaid expansion and changing funding to per capita caps or block grants, the report notes. Although per capita caps would give states more flexibility in how they administer Medicaid, the caps would likely leave gaps in funding, according to the report. This is because states would receive fixed federal grants for Medicaid spending, and would potentially have less federal funding to subsidize coverage. States would potentially need to narrow Medicaid eligibility, cut benefits or reduce payment rates to balance their budgets, according to the report.  

3. Under a potential Republican ACA replacement, premium tax credits for coverage sold on the individual market would be based on age rather than income. This would leave more people uninsured, according to the report. The analysis showed tying tax credits to age could increase uninsured rates for individuals who purchase coverage on public exchanges by 30 percent in a hypothetical Medicaid expansion state and up to 50 percent in a hypothetical nonexpansion state.

For more on this story, read Dan Balz's full report in The Washington Post.

 

More articles on leadership and management:

Trump administration committed to 'orderly transition' with ACA replacement, VP Pence says
CMS' ACA market stabilization rule: What the public thinks
More than 130 mayors urge Congress to preserve ACA

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