Home Health Analysis: Per Capita Caps in Senate Health Bill Would Cost Virginia $1.4...

Analysis: Per Capita Caps in Senate Health Bill Would Cost Virginia $1.4 Billion


From Gov. McAuliffe’s office:

Per Capita Caps in Senate Health Bill Would Cost Virginia $1.4 billion

RICHMOND – A preliminary analysis of the Senate’s proposed “repeal and replace” bill by the Virginia Department of Medical Assistance Services (DMAS) shows the per capita caps in the proposal would cost Virginia’s Medicaid program at least $1.4 billion over seven years.

The per capita caps in the Better Care Reconciliation Act of 2017 affect almost every population covered by Medicaid, and would cost Virginia’s program almost double the $708 million that the House-proposed American Health Care Act (AHCA) was estimated to cost over the same time frame.

“The legislation currently up for a vote in the United States Senate would blow a hole in Virginia’s budget and severely impair our ability to offer health coverage and long-term care to the people who need them most,” said Governor Terry McAuliffe. “The cuts in the current Senate bill would force states like Virginia to choose between cutting benefits for families who need them, slashing investments in other core services like education and transportation, or raising taxes. On behalf of Virginia taxpayers I urge leaders in Washington to drop this effort to push federal health care costs down to the states and work together to make coverage more affordable and accessible for every American.”

The difference between the impact of the House and Senate proposals on  per capita caps lies in the “annual growth factor” – the estimation of how much costs will increase in the future over a baseline estimate of Medicaid spending. The Senate bill uses a growth factor that estimates lower growth than the House bill – and both houses use a growth factor that is arbitrary. DMAS estimates costs will outpace the growth factor of both bills; that change becomes more pronounced in later years. Provisions in the BCRA that provide safety net funds to providers and eliminate Disproportionate Share Hospital allotment reductions would not directly make up for the losses Virginia would experience from per capita caps.

These are costs associated with providing care to Virginia’s children and elderly and disabled citizens. Medicaid eligibility in Virginia is limited to low-income people who are aged, blind and disabled; pregnant women and children; and children themselves. Reducing the costs to provide services to these populations would impose difficult choices on Virginia policy-makers to reduce services or provider rates.

This DMAS analysis is preliminary and reflects the legislation that was released on Thursday, June 22nd.


  • From Progress Virginia:

    Congressional Budget Office Confirms Senate Health Care Bill Bad For Everyone

    Washington, DC–The Congressional Budget Office, a nonpartisan agency that forecasts the effects of legislation, announced today the Senate version of a bill to replace the Affordable Care Act will result in 22 million American families losing their health insurance coverage.

    “Trumpcare is quite simply an attack on our families and communities. We thank Virginia Senators Tim Kaine and Mark Warner for opposing the health care bill, but we know that their opposition alone won’t be enough to save the millions of families who are now facing a serious health care crisis,” Anna Scholl, Executive Director of Progress Virginia said. “It’s absolutely outrageous that anyone would vote for a bill that prioritizes cutting taxes for the ultra-rich while millions of people in our communities will lose access to the health insurance that literally keeps them alive.”

    The Affordable Care Act resulted in more than 20 million people enrolling in health insurance programs. According to the Virginia Department of Medical Assistance Services (DMAS), because of the per capita caps in the Senate health care proposal, Virginia’s Medicaid program would lose at least $1.4 billion over seven years.


    WASHINGTON, D.C. – Today, U.S. Senator Tim Kaine, a member of the Senate Health, Education, Labor & Pensions (HELP) Committee, released a statement on the non-partisan Congressional Budget Office (CBO) cost estimate of the Senate Republican health care bill:

    “Under the Affordable Care Act, more than 20 million people gained health insurance. Under the Senate Republican health care bill, 22 million Americans will lose their health insurance, and Virginia’s families, seniors, children, and people with disabilities will face higher costs for less care, all to deliver a tax break to the wealthy. I will oppose any bill that breaks President Trump’s promises to the American people that no one will lose insurance and no one will pay more, and today’s CBO score proves the Republican health care bill shatters those promises. This is now the third CBO score on a Republican health care bill that has clearly stated millions of individuals and families would lose coverage under this proposal. It’s time my colleagues drop their rush to vote on this ‘mean’ bill that’s been rejected by the public so we can work together on improvements to the health care system that benefit all Americans.”


    ~ On CBO score of Senate Republican repeal bill ~

    WASHINGTON — U.S. Sen. Mark R. Warner (D-VA), a member of the Senate Budget and Finance Committees, issued this statement following today’s analysis of the Senate Republican health care repeal bill by the nonpartisan Congressional Budget Office:

    “Here’s what we know about the Senate proposal to repeal the Affordable Care Act: Twenty-two million more Americans will be uninsured. Medicaid will be cut $772 billion. And consumers will have less comprehensive coverage than they do now, with higher out-of-pocket costs.

    “Senate Republicans should sit down with us to have a grown-up discussion about fixing what’s wrong with the ACA instead of rushing a vote on a bad plan.”