1. Family Voices of CA Health Summit
Threats to Medicaid and Children and Youth with Special Health Care Needs
Edwin Park
@EdwinCBPP
February 27, 2017

2. Likely GOP ACA Repeal Plan
Phase out enhanced matching rate for Medicaid expansion to regular matching rate
Delay repeal of exchange subsidies for 2-3 years
Immediate elimination of individual/employer mandates
Eliminate all or most of the ACA taxes.

3. CBO Estimates of 2016 ACA Repeal Bill

4. ACA Repeal Places Medicaid at Risk

5. CYSHCN Rely on Medicaid

6. Medicaid Cuts Would Grow Over Time Under Last Year’s House GOP Budget Plan Block Grant/Cap

7. Medicaid Block Grants and Per Capita Caps: Shift Costs & Risks to StatesVS
$120
$120
$100
$100
$100
Federal cap

8. Medicaid Anti-Retroviral Drug Spending and Use More Than Doubled in 1996
The onset of the HIV/AIDS epidemic in the 1980s and early 1990s led to unexpected Medicaid costs.
Anti-retroviral prescriptions increased from 170,000 to 3 million from 1991 to 2005.
Anti-retroviral prescription spending increased from $31 million to $1.6 billion.

9. Medicaid Is Already Efficient

10. Likely State Actions in Response to Federal Medicaid Funding Cuts
Contribute much more state $ by raising taxes
Cut education, other social services
Cut Medicaid benefits, eligibility and provider payment rates. 1. 2. 3.

11. New Medicaid Flexibility: Flexibility to Cut
Individual entitlement
Eligibility
Benefits
Work requirements
Premiums and cost-sharing

12. Distribution of Medicaid Spending Means No Groups Can Be Protected
About 20 percent of Medicaid enrollment is among seniors and people with disabilities.
But they account for 50 percent of federal spending.