Congress’ health plan bill, the American Health Care Act, proposes a major restructuring to the Medicaid program. The proposal would cap the federal funding states receive on a per-Medicaid beneficiary basis, starting in 2020. Using retrospective data, Voices for Utah Children investigated the impact of these changes on Utah’s state budget, had they been enacted a decade earlier.

The chart below illustrates the Utah budget impact of the Medicaid per capita cap allotment, if it had gone into effect a decade ago. The scenario is based on the American Health Care Act and state Medicaid annual reports. Given inflation and rising health care costs, Utah could expect the budget gap for the coming years to significantly exceed what it would have been in the past.

The proposed Medicaid caps would be based on states’ per-beneficiary spending, set in fiscal year 2016, and would rise annually to match growth in the medical care component of the Consumer Price Index (M-CPI). States are already locked into their capped amount. However, according to Congressional Budget Office forecasts, Medicaid costs per beneficiary are expected to rise 0.2 percentage points faster each year than the capped amount.

Consequently, states would get less federal funding than under current law and could expect to see cuts growing each year.

States would be expected to make up any excess costs or cut benefits to enrollees. Any unanticipated health care cost growth, such as a Zika outbreak or a new opioid treatment drug, would not be accounted for in the federal per capita cap amount. 

As retrospective data illustrate, Utah consistently would have less available funding for health care costs. Today over 200,000 children rely on Medicaid coverage, including children with special health care needs. The majority of Medicaid enrollees (63%) are children. The Congressional proposal would create situations where state lawmakers choose which health services vulnerable children are eligible to receive, and which services or benefits they will not be eligible to receive. These are decisions best left up to health care providers, not politicians.

The American Health Care Act puts children’s health care and coverage at risk. Changes to Medicaid’s financing structure through a per capita cap would create large shortfalls in Utah’s state funding. These shortfalls would inevitably lead to limits placed on the program, such as a reduction in benefits, cuts to provider payments or fewer children covered. This unprecedented restructuring of the Medicaid program puts Utah children’s health care and coverage at risk.

March 30, 2017 is Love UT Give UT!

It’s a day for Utahns to give to the nonprofits that make Utah special. Every donation to Voices for Utah Children through Love UT Give UT gives Voices a chance to win matching grants and prizes—and gives you a chance to win a car!

And you don't have to wait!  Donate now at http://bit.ly/loveUTchildren.

For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.

How can you be involved?

Make a tax-deductible donation to Voices for Utah Children—or join our Network with a monthly donation of $20 or more.  Network membership includes complimentary admission to Network events with food, socializing, and opportunity to meet child advocacy experts. And don't forget to join our listserv to stay informed!

We look forward to the future of Voices for Utah Children and we hope you will be a part of our next 30 years.

Special thanks to American Express for sponsoring our 30th Anniversary Year.