The Better Care Reconciliation Act (BCRA) under consideration in the Senate would drastically alter Medicaid by limiting federal funding and shifting cost over time to both states and Medicaid enrollees. Starting in 2020, the Senate bill would mandate per capita caps for most populations, including older adults and people with disabilities, and allow states to choose between a per capita cap and a block grant for non-elderly, non-disabled adults. Importantly, the BCRA’s proposed growth rates for the per capita caps and block grants do not keep pace with the growth in Medicaid spending, leaving states and consumers increasingly vulnerable over time.
In a new blog series, the AARP Public Policy Institute projects the impact of the Senate bill’s proposed per capita caps for eight states over twenty years, from 2017-2036. Across the eight states included in this analysis- Alaska, Colorado, Kansas, Maine, Nevada, North Dakota, Ohio and West Virginia- Medicaid cuts could reach $316 billion through 2036.