Better Health Care Act Deepens Ohio Medicaid Cuts; Senate Legislation Creates Shortfall of $58-93 billion by 2030

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The Center for Community Solutions updated its fiscal estimates on the impact of the American Health Care Act (AHCA), now known as the Better Care Reconciliation Act (BCRA) as it works its way through the Senate. Compared to the House, the Senate has further deepened the shortfall in funding to Ohio’s Medicaid program. Over 10 years, BRCA would reduce Ohio Medicaid funds between $58 billion and $93 billion.

It puts the health care of children, persons with disabilities, and older adults at risk. It will result in hundreds of thousands of Ohioans losing their health care coverage, with nowhere to turn

The Center for Community Solutions updated its estimates on the impact of the American Health Care Act (AHCA), now known as the Better Care Reconciliation Act (BCRA) as it works its way through the Senate.

Compared to the House, the Senate has further deepened the shortfall in funding to Ohio’s Medicaid program through the implementation of per-capita caps in two ways. First, the Senate removed the additional protections for the elderly and disabled and made the medical consumer price index (CPI-M) uniform across all groups affected by the legislation. Second, by 2025, the legislation will reduce the per capita inflationary number by moving from CPI-M to the consumer price index for all goods (CPI-U), from 3.8 percent to 2.4 percent.

To understand the impact, CCS remodeled its earlier estimates to reflect the Senate’s changes, using a 10-year time frame. A few key findings:

1. The AHCA would cause a shortfall of $41 billion-$71 billion for Ohio’s Medicaid program by 2030. The BRCA increases the shortfall range to $58 billion-$93 billion.
2. Removing protections for the elderly and disabled would create a cut of $2 billion – $2.2 billion by 2025 before     CPI-U is implemented.
3. Differences between the AHCA and BCRA by eligibility group follow:

Loren Anthes, public policy fellow of Community Solutions’ Center for Medicaid Policy and the lead researcher behind the report, said, “The Senate goes much further than the House in limiting spending through a per capita cap, increasing the shortfall by upwards of 22 billion dollars by 2030. Changing the consumer price index number by just a few points substantially decreased federal funding to Ohio, and Ohio policymakers will face impossible choices about who and what to cover if this becomes law.”

John Corlett, president and executive director of The Center for Community Solutions and a former Ohio Medicaid director, commented, “Ohio has worked hard to make its Medicaid program among the most efficient and value-based in the nation. Because of that, it leaves Ohio with few places to turn to make the billions of dollars in cuts. It puts the health care of children, persons with disabilities, and older adults at risk. It will result in hundreds of thousands of Ohioans losing their health care coverage, with nowhere to turn.”

Background on Estimates

  • The estimates include Fiscal Year 2019 through Fiscal Year 2029, which adds four years of data relative to the initial CCS report.
  • The Senate legislation included a provision which allows states some flexibility in establishing a baseline estimate. These estimates maintain the baseline projections from the previous CCS report built on data from the Kaiser Family Foundation.
  • The CPI-M number for the new estimate is 3.7 percent and the CPI-U number is 2.4 percent.
  • This model does not remove medically complex children from the caps as proposed by the Senate legislation.

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A nonprofit, non-partisan think tank founded in 1913, The Center for Community Solutions focuses on solutions to health, social, and economic issues. With offices in Cleveland and Columbus, Community Solutions identifies, analyzes, and explains key health, social, and economic data and issues, and proposes non-partisan solutions to improve the lives of Ohioans. For more information, visit http://www.CommunitySolutions.com and follow us on Facebook.com/CommunitySols; Twitter @CommunitySols; and Instagram @Community_Solutions

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John Corlett
The Center for Community Solutions
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Eboney Thornton
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