WASHINGTON — A Republican bill to repeal Obamacare and redistribute federal funds in block grants would take money from 34 states — including Nevada — over the first seven years, according to an analysis released Wednesday.
Avalere Health, a Washington-based policy firm, said the GOP health care plan under consideration in the Senate would reduce federal spending by $215 billion on Medicaid expansion and subsidies for private insurance by 2026.
Nevada would lose $2 billion from 2020 to 2026, according the analysis.
Caroline Pearson, Avalere senior vice president, said the bill “would significantly reduce funding to states over the long term, particularly for states that have already expanded Medicaid.”
“States would have broad flexibility to shape their markets but would have less funding to subsidize coverage for low- and middle-income individuals,” Pearson said.
Those concerns were aired by a bipartisan group of 10 governors earlier this week in letters to Senate Majority Leader Mitch McConnell, R-Ky., and Senate Minority Leader Charles Schumer, D-N.Y.
Nevada Gov. Brian Sandoval, a Republican, was one of the 10 governors who urged the Senate to shelve the GOP bill and pursue a bipartisan approach to reform the nation’s health care system.
The new GOP bill was filed last week by Republicans Lindsey Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada and Ron Johnson of Wisconsin.
The bill would eliminate the individual and employer mandates under the Affordable Care Act, commonly known as Obamacare, and redistribute funds for private insurance subsidies and Medicaid expansion in block grants to states.
The Senate sponsors have said four states that receive nearly 40 percent of federal spending for expansion and public subsidies — Maryland, California, Massachusetts and New York — would see decreases in federal spending that would be redistributed to other states.
Heller said Nevada would see a 30-percent increase in federal funds because of the redistribution of spending through block grants — a claim that is contradicted by the Avalere analysis.
A Heller spokeswoman, Megan Taylor, said the bill would give “Nevada ultimate flexibility to continue covering its Medicaid expansion population or come up with new ways to make sure of it.”
Taylor said Nevada would no longer be on the hook for Obamacare’s 10-percent funding match and the state could use block grant funds to help cover individuals on traditional Medicaid.
States would be given flexibility to spend the funds on public health care plans designed by governors and legislatures. States would also be given the ability to waive regulations.
Despite the flexibility, Sandoval and the bipartisan group of governors voiced concern about the Medicaid cuts and the shift of the financial burden to the states.
The Avalere analysis also found that state waivers would likely erode protections for those with pre-existing conditions. Cassidy, a physician, said protections for those with pre-existing conditions would continue to exist.
President Donald Trump and House Speaker Paul Ryan, R-Wis., have endorsed the latest Senate plan, which still lacks the 50 votes needed for passage under budget reconciliation rules that expire at the end of next week.
McConnell has not scheduled a vote on the bill. And the fate of the bill remains with three undecided lawmakers who killed the last GOP bill in July: John McCain of Arizona, Susan Collins of Maine and Lisa Murkowski of Alaska.
The Senate Finance Committee has scheduled a Monday hearing on the bill, despite the lack of an independent Congressional Budget Office analysis of cost and coverage of the new legislation.
Chairman Orrin Hatch, R-Utah, said the hearing would allow lawmakers to “delve deeper” into the policies of the bill
But Sen. Ron Wyden, D-Ore., the ranking Democrat, said that without a CBO analysis, the hearing was part of a Republican “sham process that makes a mockery of regular order.”
The hearing comes as another Senate committee with oversight on health stopped its efforts to write a bipartisan bill to stabilize the insurance markets and provide time to reform health care.
Sen. Lamar Alexander, R-Tenn., the chairman of the Senate Health, Education, Labor and Pensions Committee, said in a statement that he and ranking Democrat Sen. Patty Murray of Washington were unable to find “necessary consensus” to write a bill that could be enacted.
The collapse of the bipartisan plan to shore up the insurance markets puts more scrutiny on the Graham-Cassidy-Heller-Johnson bill. No major medical association has endorsed the plan.
The American Medical Association, AARP, Planned Parenthood and others have urged the Senate to reject the plan.
Meanwhile, the Avalere analysis shows the state that would see the biggest hit would be California, $78 billion. New York would lose $45 billion in federal funds from 2020 to 2026. Both expanded Medicaid.
Texas, which did not expand Medicaid, would be the biggest winner with $35 billion in additional federal spending during that period.
Avalere disclosed that funding for analysis came from the left-leaning Center for American Progress. Avalere said it maintained full editorial control of the analysis.
Contact Gary Martin at 202-662-7390 or firstname.lastname@example.org. Follow @garymartindc on Twitter.