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The Latest Republican Efforts to Repeal and Replace Obamacare

       Several months ago I wrote about the first attempt to repeal and replace Obamacare since the 2016 elections, which failed.  The latest attempt, revived by New Jersey Congressman Tom MacArthur, passed thru the House of Representatives.  The Senate, in secret meetings that have stirred more controversy, put out its own version which has yet to be voted on.

       The Congressional Budget Office has estimated that more than 20 million people will lose health care coverage if Obamacare is repealed and the Senate version is adopted.  The Senate bill includes cuts in Medicaid funding.  Remember that part of Obamacare includes an option for states to expand their Medicaid programs with additional federal funds to support that expansion.  New Jersey took full advantage of Medicaid expansion.

       The question I am repeatedly asked is, “what does this mean for Medicaid?” – meaning the Medicaid programs that cover long term care.  It is still too early to tell with any certainty what Congress and President Trump will actually get passed into law – since compromises along the way can dramatically change things.  We can, however, look at what is currently on the table.

       The Senate version of health care reform changes Medicaid to block grant funding instead of what it is now, open entitlement.  This means that the federal government would provide states with a set amount of money for its Medicaid programs, no matter how many people are entitled to benefits.  This would be instead of the way it works now where funds are provided to cover everyone who meets the eligibility requirements.

       With an aging population and more people anticipated to need long term care in future years it means states won’t get more money from the federal government as the number of recipients increases.  They’ll have to come up with the rest of the money on their own.  That doesn’t bode well for a state like New Jersey which doesn’t exactly have its financial house in order.

       While cuts in Medicaid funding will directly affect many New Jerseyans who have health insurance thru Medicaid, as time goes by and Medicaid funding starts to dry up it isn’t hard to see how this will affect those seeking long term care Medicaid benefits as well.  New Jersey is likely to make cuts because there will be less money to go around the various Medicaid programs.

       Again, all this – at least for now – is just speculation.  A few hurdles remain.  First Senate Republicans have to figure out if they can get the necessary votes to pass their version, maybe the biggest hurdle.  Then that bill goes back to the House of Representatives to be reconciled with the House’s bill.  Then both houses of Congress must approve the final bill after which it goes to President Trump for his approval.  Changes can – and frequently do – occur at any point along the way.    We’ll just have to keep an eye on things.  It looks like this fight will continue through the fall before we get any clarity.  Stay tuned.