The Long-Term Care Discussion Group Of Block Grants & Waivers: What Medicaid Changes Could Mean for Long-Term Services and Supports The Long-Term Care Discussion Group Judith Solomon April 24, 2017

And Federal Spending Cuts Would Grow Over Time Medicaid Spending Cuts in House GOP Plan Would Total $839 Billion Over 10 Years And Federal Spending Cuts Would Grow Over Time To download graphic, see www.cbpp.org/social-media-graphics-on-house-republican-aca-repeal-plan

Federal Medicaid Per Enrollee Spending Capping Rate of Growth in Medicaid Spending Per Enrollee Leads to Severe Cuts Over Time Federal Medicaid Per Enrollee Spending Sources: CBPP analysis of BLS and CBO data

Medicaid Per Capita Cap Would Shift Costs to States in Three Ways Cuts Federal Funding Over Time Explicit cuts in funding based on structure of the cap: Baseline funding cap per beneficiary is set too low Rate of growth in spending per enrollee doesn’t keep pace with health costs Unanticipated increases in expected state Medicaid costs Increases in health care costs that will likely occur, but are not factored into the established growth rate

Medicaid Long-Term Services and Supports (LTSS) Users Accounted for Nearly Half of Medicaid Spending, FY 2010 Enrollees Expenditures 57% 94% 22% Comment/Question: 2% 21% 4% Total = 66.4 million Total = $369.3 billion NOTE: Individuals who used both institutional and community-based services in the same year are classified as using institutional services in this figure. SOURCE: KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because the 2010 data were unavailable, 2009 data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

Judith Solomon solomon@cbpp.org @JudyCBPP www.cbpp.org