A Republican health plan to replace Obamacare could throw 60,000 Delawareans off Medicaid.
The most immediate effect could be removing 11,000 people who qualified for benefits as part of the state’s 2014 expansion of Medicaid under the Affordable Care Act, according to Steve Groff, Medicaid director for Delaware.
“But, the proposal to set per-capita caps on Medicaid funding going forward would ultimately result in continued erosion of federal funding for the program,” said Groff.
These caps set spending limits on how much the federal government provides a state for each Medicaid enrollee.
The per-capita caps in the GOP proposal are tied to inflation, so if health care spending increases faster than the Consumer Price Index, Delaware will be on the hook for all those cost overruns.
Delaware’s Department of Health and Human Services determined it would cost the state $100 million just to provide healthcare to the 11,000 people added under the 2014 expansion.
If federal funding erodes and health costs spike, the state could have to dump the additional 50,000 people who qualified for an earlier expansion of Medicaid in 1996.
The GOP has promised states increased flexibility in administering health care to deal with Medicaid funding cuts.
But those details about flexibility aren't in the new bill.
“So all we see is how funding will be limited without any understanding of what flexibility we might have in order to address those funding shortfalls we expect down the road,” said Groff.
A Congressional Budget Office Report this week determined the Republican health plan would lead to 14 million fewer Medicaid enrollees nationwide by 2026.
That analysis also found the Republican plan would reduce federal deficits by $337 billion over that same time period.