The bill would repeal the individual and employer mandate and penalties for companies who don’t offer affordable plans to their employees. Pre-existing conditions would still be covered, but states could waive that provision as well as certain mandated coverage such as maternity leave.
States that have already expanded Medicaid will see those expansions ended by 2020. States would be given block grants with which to distribute Medicaid funds until 2026.
Ciara Zachary, a health policy analyst at the N.C. Justice Center, a progressive research organization, said the bill is more deadly than other attempts to repeal ACA because it puts a deadline on block grants.
“What are states going to do to keep people covered after that?” she said.
Katherine Restrepo, director of healthcare policy at the John Locke Foundation, a conservative think tank, said this bill is a step in the right direction.
“With federal block grants, North Carolina will hopefully be granted more flexibility in restructuring not only its private health insurance market but also its Medicaid program,” she said.
Restrepo said much of the debate surrounding repealing the ACA centers on how to redistribute funds rather than how to improve access to health care. She said North Carolina can lower health care costs without any federal intervention.
Zachary said the adjustment would be destructive for North Carolina.
“Medicaid is a program that grows with need, and the per capita plan won’t take those needs into account,” she said.
States would receive a per capita allotment of funds replacing the previous system of reimbursement. According to the bill, funding redistribution would favor states who did not expand Medicaid under the ACA.
The bill would end reimbursements for non-abortion services provided by Planned Parenthood in favor of funding community health services.
Zachary said various insurance providers and organizations, such as the AARP, have expressed disapproval over the bill.
“In some ways I think we’re playing a political game without thinking of the people who will be impacted,” she said.
She said congressional Republicans have given themselves a Sept. 30 deadline to repeal the ACA.
The Congressional Budget Office has not yet released a report on the Graham-Cassidy Bill and until then, congressional Democrats say the bill should not be pushed forward according to a statement by Sen. Bernie Sanders, I-Vt.
Despite this, hearings over parts of the bill are expected to occur soon.