NJHA’s Ryan: New attempt to kill ACA would cost N.J. $3.9B in funds

By Anjalee Khemlani
Princeton | Sep 21, 2017 at 9:18 am

The last-ditch attempt to replace the Affordable Care Act, a proposal by U.S. Sens. Lindsey Graham and Bill Cassidy, would cost New Jersey $3.9 billion in federal health care funds by 2026, according to the New Jersey Hospital Association.

NJHA CEO and President Betsy Ryan took to Twitter on Wednesday night to tell the sponsors of the bill, which was supposed to go nowhere, and President Donald Trump as much.

When Trump tweeted he would not be signing the Graham-Cassidy bill if it didn’t cover pre-existing conditions, Ryan replied to Trump and Graham that the bill allows waivers for pre-existing conditions that would increase the cost for patients.

The states most affected by the proposed funding cuts include California, New York and Massachusetts, with New Jersey ranked fourth.

Ryan said in a statement Tuesday that the loss in funding would come from the state’s Medicaid program, which currently provides 1.8 million residents, including one in every three children in the state, access to health care.

The new bill, instead, wants to use a block grants, or lump sums of federal dollars to states, which would cut $240 billion in federal health care funding by 2026, Ryan said.

“Once again, we’re staring down a bad bill that would hurt millions of people, and Senate leadership seems intent on ramrodding it through the process with insufficient information and no opportunity for public input,” Ryan said. “Since there is no CBO score of the Graham-Cassidy bill, we feel it’s imperative to note the devastating impact this measure could have on 1.8 million New Jersey residents who count on Medicaid for their health care — not to mention the significant hole it will shoot through the New Jersey state budget, which would be felt by taxpayers across the state.”

In a letter to Congress, Ryan laid out the three main problems, and urged the New Jersey delegation to continue supporting health care funding in the state and search for bipartisan solutions rather than vote on a fast-tracked bill.

1. The bill would result in millions losing health coverage.

The bill would repeal the ACA’s individual and employer mandate penalties, a change the CBO previously estimated would result in 14 million fewer insured individuals after one year and 32 million over 10 years. In addition, the bill would reduce the amount of funding for traditional Medicaid by transitioning financing for the program to a per capita cap model with trend factors that are generally below historic spending growth, potentially jeopardizing coverage and services for our most vulnerable.

2. The bill would erode key protections for patients and consumers.

The bill would repeal the ACA’s Medicaid expansion, Basic Health Program and Health Insurance Marketplace subsidies, effective Jan. 1, 2020, and establish a block grant program for states to create their own health care programs from 2020 to 2026. States could use the funds to help individuals enroll in coverage, but they also could use the funds for other health-related purposes. This change would allow states to waive many insurance rules for coverage provided through the block grant program. States could eliminate some or all of the essential health benefits and allow insurers to charge individuals with pre-existing conditions any amount in premiums, effectively pricing many individuals out of coverage.

3. The bill fails to stabilize the insurance market in the short or long term.

The bill fails to fund the cost-sharing reductions in the short term (2018 and 2019), while providing a separate fund for insurers to help stabilize the insurance markets in 2019 and 2020 (but not 2018). The CBO previously estimated that failure to fund the CSRs in 2018 would increase premium rates by 20 percent and increase the federal deficit by $6 billion that year. In addition, the new grant program for states would end after seven years, potentially creating massive disruption in the health care system as millions of individuals may lose their source of coverage.

While admitting the ACA isn’t perfect, Ryan said the health law has reduced the number of uninsured in the state to “historic lows of 9 percent.”

Gov. Chris Christie on Wednesday voiced his opposition to the Graham-Cassidy bill, according to multiple reports.

The Senate has until Sept. 30 to vote on the bill.

Anjalee Khemlani | akhemlani@roi-nj.com | AnjKhem