In a blistering statement released Friday morning, the association representing state Medicaid directors took Congress to task for rushing a bill to the floor that would completely overhaul the nation’s health care system in just a few years and deeply cut the federal money available to states to cover hundreds of millions of people.
“We are concerned that this legislation would undermine efforts in many states and fail to deliver on our collective goal of an improved health care system,” wrote the board of the National Association of Medicaid Directors (NAMD), a 12-member body elected by all 56 U.S. Medicaid directors.
Matt Salo, the executive director of the NAMD, told TPM that while it’s nearly impossible for his members to achieve “lock-step unanimity” on anything, especially major, controversial pieces of legislation, the board “felt the concerns were strong enough and universal enough that this was an important message to say on behalf of their peers.”
The Medicaid directors’ association is the latest stakeholder to come out against the Graham-Cassidy bill that Congress may vote on by the end of the month, joining with insurers, hospitals, doctors, medical groups and Republican and Democratic governors who oppose the legislation’s deep cuts to Medicaid and weakening of protections for people with pre-existing conditions.
In particular NAMD notes that under the bill, states would have only two years to complete redesign their health insurance systems and more than half of them would be dealing with a deep funding cut at the same time.
“The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated,” the letter warns. “States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities. The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities.”
Salo said that while their names are not on the letter, multiple Medicaid directors from red states have told him privately that they endorse its criticisms of the Senate legislation.
“We have members whose governors are strongly in favor of the bill who would be in a tough position if they spoke out,” he explained. “But I’ve talked to lots of people who said, ‘Politically, my state is going in one direction, but I’m extraordinarily concerned about what it would do to my state and its people in the long term.'”