Republican Nevada Sen. Dean Heller, the self-proclaimed savior of Medicaid, apparently doesn’t understand the legislation that he’s signed on to as a replacement for the Affordable Care Act. Heller is touting the Cassidy-Graham plan (he calls it the Cassidy-Graham-Heller plan to make people think he helped write it) as “the drain the swamp” be-all and end-all Obamacare replacement bill. What he’s not telling voters back home (maybe because he doesn’t know it’s in the bill?) is that it would destroy Medicaid.
It would cause many millions of people to lose coverage, radically restructure and deeply cut Medicaid, increase out-of-pocket costs for individual market consumers, and weaken or eliminate protections for people with pre-existing conditions.
That’s because the plan would eliminate the ACA’s marketplace subsidies and enhanced matching rate for the Medicaid expansion, replacing them with an inadequate block grant whose funding would shrink further over time (compared to current spending levels) and then disappear altogether after 2026. The plan would also convert Medicaid’s current federal-state financial partnership to a per capita cap, which would cap and cut federal Medicaid per-beneficiary funding for seniors, people with disabilities, and families with children. Finally, it would allow states to waive ACA provisions that prohibit health insurance plans from placing annual or lifetime limits on coverage and require them to cover key services.
All states would eventually face deep and growing cuts to federal coverage programs due to the plan’s radical structural changes to these programs, which would make federal funding far less responsive to need. But some states would suffer immediate, disproportionate harm because the block grant would not only cut overall funding for the Medicaid expansion and marketplace subsidies but also redistribute the sharply reduced federal funding across states, based largely on criteria unrelated to states’ actual spending needs and the coverage gains they’ve achieved under the ACA.
So there’s that. Heller’s performance on this just keeps getting more and more ridiculous, as does his apparent conviction that he can keep getting away with lying to Nevada voters.