If states get more flexibility to run their Medicaid programs, a loss of billions in funding won't harm care for beneficiaries, HHS Secretary Tom Price said during a CNN town hall Wednesday night.
Audience members peppered Price with questions regarding a proposal to slash $880 billion between 2017 and 2026 from Medicaid if the House GOP's American Health Care Act becomes law. Price and Trump support the law.
“You're falling into the same old trap of individuals who are measuring the success of Medicaid by how much money we put into it,” Price said. “We ought not be measuring programs by how much money we put into it, we ought to be measuring them by whether or not they work.”
A report by the Congressional Budget Office this week predicted that some of the 31 states and the District of Columbia that expanded Medicaid would terminate the expansion, as they would no longer receive enhanced federal match payments for that population. In addition, some states that would have expanded eligibility in the future will choose not to do so.
The AHCA would cap federal payments to the states per enrollee for all Medicaid-eligible groups at the rate of the medical component of the Consumer Price Index, which lags behind actual Medicaid per-capita costs.
Price said that Medicaid currently is not working. As many as one in three doctors are not accepting Medicaid patients, Price said.
In fact., a survey by the American Academy of Family Physicians found that 68% of its members accepted new Medicaid patients in 2016 --- the highest level of Medicaid acceptance since 2004.
Price argues that if states got greater flexibility to run their Medicaid programs and less Washington oversight, access and quality of care under the program would improve.
Joan Alker, a Medicaid expert at Georgetown University disagrees with that hypothesis.
"In practical terms what does that mean? States could get new flexibility to limit enrollment," Alker wrote in a blog post. "They could gain the ability to limit enrollment directly by imposing enrollment caps or rolling back eligibility; or indirectly by putting up barriers such as imposing work requirements or lockout periods, which reduce enrollment."