Alaska could get relief from Senate repeal bill's Medicaid cuts

The Senate’s Obamacare repeal bill may protect Alaska and up to four other sparsely populated states from major cuts to Medicaid through 2026, a potential boon to the home of pivotal GOP swing vote Sen. Lisa Murkowski. The plan from Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) allows a limited number of states to opt out of its new Medicaid financing system, which would give states set sums to run their programs and do away with the open-ended entitlement that exists today. Story Continued Below Murkowski helped kill the GOP’s “skinny” repeal bill in July and is being heavily courted by Republicans to support the latest repeal effort. Murkowski has remained publicly noncommittal. But Republicans will likely need her if they want to make good on their campaign pledge to repeal Obamacare. Republicans can only lose the votes of two of their 52 senators and still have Vice President Mike Pence cast a deciding tie-breaker vote to pass the bill. The Medicaid delay would potentially apply to Alaska, Wyoming, South Dakota, North Dakota and Montana, based on their low-density populations. Those states would be allowed to opt out on the bill's fixed payments if certain health spending conditions are met in the prior year or the HHS secretary determines the new funding system is insufficient. The chance to opt out would end in 2026. It is unclear whether all five states would qualify, according to Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities. Those that do would continue to get Medicaid funding in the current fashion. Park said the difference between states that opt out and other states could be substantial. A similar provision existed in the Senate’s previous repeal bill. There are reasons that Alaska — a large but sparsely populated state — would need additional funding. “Alaska is so unique,” Graham said. “It’s like 750,000 people and a third of the size of the United States. So when they say they’re different, they really are.” Graham said Alaska will fare well under the bill and has made that pitch to the state’s senators. But independent analysis shows the state, over time, would see less funding than it gets today. The Center on Budget and Policy Priorities estimated the state funding would drop by $ 255 million in 2026. “It will not only work for them — it’s as good as it can be for them,” Graham said Tuesday. “They have to compare it with what’s coming. What’s coming over time is the collapse of Medicaid. It’s just fiscally unsustainable. We have to get on a fiscally sustainable path.”
Utne Altwire: healthcare

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