State Medicaid Leaders Call Senate Health Care Bill ‘Unworkable’

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A bipartisan group representing directors of state Medicaid programs opposes funding cuts in the Senate health care bill, calling the new growth rate “insufficient and unworkable.”

The National Association of Medicaid Directors released a statement on the Better Care Reconciliation Act on Monday which said the cuts more than outweigh parts of the bill they support.

“Changes in the federal responsibility for financing the program must be accompanied by clearly articulated statutory changes to Medicaid to enable states to operate effectively under a cap. The Senate bill does not accomplish that,” the statement says. “It would be a transfer of risk, responsibility, and cost to the states of historic proportions.”

The Senate health care bill proposes shifting Medicaid financing to block grants for the states depending on enrollment, and aims to phase out the federal funding implemented under Obamacare for Medicaid expansion.

“While NAMD does not have consensus on the mandatory conversion of Medicaid financing to a per capita cap or block grant, the per capita cap growth rates for Medicaid in the Senate bill are insufficient and unworkable,” the statement says.

The NAMD has been a longtime advocate of Medicaid reform, the statement says, and are appreciative of portions in the bill that would give directors more of a voice in the way the program is run.

But, the statement notes, “no amount of administrative or regulatory flexibility can compensate for the federal spending reductions that would occur as a result of this bill.”

Proposed Medicaid cuts have been cause for concern among some Republicans, like Nevada Sen. Dean Heller, who said Friday he couldn’t support the bill, and West Virginia Sen. Shelley Moore Capito who said in a statement Thursday she is “evaluating” the impact the bill would have on her constituents who benefited from the Medicaid expansion.

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Write to Alana Abramson at Alana.Abramson@time.com