(WASHINGTON) — A new analysis finds that blue states could lose a significant amount of federal funding for health care under the Graham-Cassidy bill.
The Kaiser Family Foundation estimates that if Graham-Cassidy became law, the federal government would spend $160 billion less from 2020-2026 to expand health insurance coverage. And 35 states, plus the District of Columbia, would face losses in federal funding.
Graham-Cassidy — named for the two Republicans spearheading the bill, Sen. Lindsey Graham, R-S.C., and Sen. Bill Cassidy, R-La. — is the latest effort by Senate Republicans to follow through on a campaign promise to repeal and replace Obamacare. The bill works by redistributing federal funds that would have been used for Medicaid expansion or insurance subsidies. The funds would be given to states in the form of block grants, which Republicans say would give states enormous discretion on how to provide coverage.
But the Kaiser report shows that the redistribution is not equal.
New York, for example, stands to lose 35 percent of the money it currently receives from the federal government to subsidize health insurance and pay for Medicaid.
But Mississippi, the report estimates, could see a whopping 148 percent gain in federal funding under Graham-Cassidy. States that could see increases in funding are states that chose not to expand Medicaid coverage under Obamacare.
Non-expansion states, according to Kaiser, could gain $73 billion, while Medicaid expansion states could lose $180 billion.
Next week, the Senate will vote on Graham-Cassidy, and all eyes are on three senators who could decide its fate: Sen. Lisa Murkowski, R-Alaska; Sen. Susan Collins, R-Maine; and Sen. John McCain, R-Ariz. Alaska and Arizona will face moderate losses in federal funding, while Maine, which did not expand Medicaid, stands to gain 8 percent in federal funding.
The top five losers in federal funding as a percentage compared to current funding include New York (-35 percent), Oregon (-32 percent), Connecticut (-31 percent), Vermont (-31 percent) and Minnesota (-30 percent).
The winners? Mississippi (148 percent), Texas (75 percent), Kansas (61 percent), Georgia (46 percent) and South Dakota (45 percent).
The large unknown that remains is what happens in 2026, when block grants end under Graham-Cassidy. Kaiser notes that if that money isn’t renewed, funding would decrease by $240 billion in 2027 alone.
“Graham-Cassidy would be the biggest evolution of federal money and responsibility to states ever,” Larry Levitt of the Kaiser Family Foundation said. “So until this passes, there’s just no way to know what kinds of changes people face, because it will be different in every state.”
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