Wednesday, March 8, 2017

House Releases “Repeal and Replace” Legislation

Drew Thies

House Energy & Commerce Committee - Photo C-SPAN
House leadership announced late Monday plans to repeal and replace The Affordable Care Act, also known as Obamacare. In addition to making significant changes to health exchange markets, the plan also includes Medicaid reforms that fundamentally change federal program funding.


The bill, known as the American Health Care Act, changes the way in which the federal government contributes to state Medicaid programs. It divides populations into distinct categories, then puts caps on the federal contribution to each of those population groups.


Beneficiaries are divided into five categories: aged, disabled, children, Medicaid expansion adults, and other adults. Each state would receive a dollar amount for each person in each category in the state.


Nursing centers would receive funding from the federal aged and disabled allocations. The state would then decide how to spend the funds within the categories. States could spend the funds on long term care facilities, on home health, on acute care or any combination of health care providers, up to the cap.


The American Health Care Association is concerned that these caps do not take into account increasing costs of care for these population groups nor do they mandate the amount of Medicaid funds that are spent on nursing care.


The legislation is passed through a budget process known as reconciliation. The process is used to avoid the potential of a filibuster in the Senate, which requires 60 votes to override. Reconciliation legislation operates on a stricter set of parliamentary rules than other bills, though only requires 51 votes to pass the Senate with no threat of filibuster.


The House Ways and Means and Energy and Commerce committees will hold hearings and mark up the legislation today. Republicans hope to pass it through the House process and on to the Senate within the coming weeks.

AHCA/NCAL members only, who wish to learn more about the contents of the bill can view a webinar here.

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