The Senate GOP’s Obamacare repeal bill would provide $1.8 trillion in tax credits for people buying insurance through exchanges.
But there’s one crucial detail missing from the Senate GOP plan: how much money would be spent on Medicaid, the federal-state health insurance program for the poor.
In a surprise announcement on Tuesday, the Senate Health Committee voted down an amendment from Sen. Lamar Alexander (R-Tenn.) that would have provided $1 trillion in Medicaid funding over 10 years.
The $1 billion in Medicaid money would not have been paid to states that opted out of the ACA Medicaid expansion.
Instead, it would have been spent on the Centers for Medicare and Medicaid Services, which runs the Medicaid program.
Under Alexander’s amendment, states would have to provide the federal government with at least $8 billion in additional Medicaid funding per year to cover the cost of the Medicaid expansion, which is the cornerstone of Alexander’s repeal bill.
The additional $8bn would have covered about $700 billion in spending on the Medicaid system over the next decade, according to the Congressional Budget Office.
A second amendment from Alexander that would’ve required states to increase Medicaid eligibility requirements would have added an additional $1,300 billion in funding over the same period.
That $1 million extra would have paid for about $1 in Medicaid expansion spending per person over the 10-year period, according the CBO.
But even if the $1 tranche of funding had gone to states, it wouldn’t have been enough to offset the $2.5 trillion in additional spending the Senate Republican health bill would require.
In addition, the additional Medicaid money for states would also have been required to offset some other federal spending cuts.
In other words, the total Medicaid spending on states over the decade would have exceeded the amount of additional funding the Senate Republicans proposed for Medicaid, according an analysis by the Center on Budget and Policy Priorities.
The Senate bill would also leave states with the option of ending the Medicaid expansions, though the Senate would still have to make Medicaid enrollment decisions on a state-by-state basis.
And the Senate bill, which passed by a vote of 67 to 31, would also give states the option to phase out Medicaid expansion coverage.
That option would require states to decide on whether to extend coverage to their residents in 2019 or 2020, rather than to the entire population of the state by 2026.