The Medicaid and CHIP Payment and Access Commission (MACPAC) discussed a range of alternative Medicaid financing options, including block grants, capped allotments, and per capita caps at its Jan. 26 meeting. Commissioners did not issue recommendations regarding any alternative funding proposal, but noted that any future changes should fully consider differences in state program designs, medical service costs, and health-care delivery spending among different beneficiary types.
As part of the discussion, the commission reviewed elements in House Speaker Paul Ryan’s (R-Wis.) A Better Way proposal, and Rep. Pete Sessions’ (R-Texas) and Sen. Bill Cassidy’s (R-La.)World’s Greatest Healthcare Plan Act of 2016 (H.R. 5284, S.2985).
Commissioners cited concerns regarding the overall complexity of implementing a new funding model and noted potential significant decreases in federal financing for states with generous Medicaid programs. Commissioners also highlighted the need to consider additional program spending not linked to specific enrollees or services, such as disproportionate share (DSH) payments, non-DSH supplemental payments, and uncompensated care pools.
The next meeting is March 2, 2017.