May 2017

Trump Administration Gives Money to Florida Hospitals Instead of Encouraging Medicaid Expansion

The Trump Administration will increase the amount of money in the uncompensated care fund for hospitals rather than encourage Florida to to give health insurance to low income people through the Medcaid expansion. Instead of having a broad range of health care services covered by medical insurance (Medicaid) hospitals will have more of their uncompensated care covered when people show up in their emergency medical departments.


Affordable Care Act Still in Place Despite House Actions

From the Center on Budge tand Policy Priorities:

"It is important to emphasize that, at this time, the ACA is still law and its provisions are still in place. People’s coverage hasn’t changed, and open enrollment is on schedule for November."

On Thursday, the House of Representatives passed the American Health Care Act (AHCA). The bill now moves to the Senate, where the bill will likely change and then to a conference committee or a vote on the Senate bill in the House.

This process will take time, and we have no way of knowing now what provisions, if any, will be enacted and signed into law. We do know that many people who gained coverage due to the Affordable Care Act (ACA) are confused and worried about what is going to happen to their coverage. It is important to emphasize that, at this time, the ACA is still law and its provisions are still in place. People’s coverage hasn’t changed, and open enrollment is on schedule for November. 

As passed by the House, the AHCA would dramatically reverse the gains in coverage that we’ve made since the passage of the ACA. For an in-depth look at the key provisions in the AHCA, please see a summary of the AHCA from our friends at the Kaiser Family Foundation.

We will continue to follow the progress of this bill, and will keep you informed of any updates as it proceeds through the Senate. The Center on Budget and Policy Priorities website at includes numerous papers and resources on the AHCA and is updated on an almost daily basis with new material.

As noted, the ACA is still in place and it’s important to continue our work to help people get enrolled. To this end, we are planning an upcoming webinar that will review changes that were in the finalized Department of Health and Human Services (HHS) rule published last month. We will let you know as soon as we set the date for the webinar. 

The new HHS rule would make sweeping changes in special enrollment periods (SEPs) and the dates for the upcoming open enrollment period for 2018 coverage. States and State-Based Marketplaces that do not rely on have some additional flexibility related to several provisions of the rule, which we will explain in more detail during the webinar. 

If you have any questions or concerns, please don’t hesitate to reach out to us at

For additional resources and information on health reform, please see our Health Reform: Beyond the Basics website. For additional policy updates, please see our main organization website,

Medicaid Cuts in House ACA Repeal Bill Would Limit Availability of Home and Community Based Services

From the Center on Budget and Policy Priorities:

 The House-passed bill to “repeal and replace” the Affordable Care Act (ACA), which the Senate is now considering, would make home-and community-based services (HCBS) that states fund through Medicaid especially vulnerable to deep cuts. The House bill would radically restructure Medicaid’s federal financing and effectively end the ACA’s Medicaid expansion

 Facing steep cuts in their overall federal Medicaid funding, states would likely curtail HCBS  programs, which in 2013 allowed almost 3 million seniors and adults and children with disabilities to receive care at home instead of in a nursing home.

 The share of Medicaid expenditures for long-term services and supports that states allocate to HCBS has climbed from 18 percent in 1995 to 53 percent in 2014, with the number of people served with HCBS rising dramatically as well. States now spend more for HCBS than for nursing home care.

 The House bill —officially the American Health Care Act (AHCA) —would place a fixed cap on per-beneficiary federal Medicaid funding, cutting federal funding to the states by growing amounts over time. Capping and cutting federal funding would force many states to make excruciating decisions on whom they cover because unlike most services in Medicaid, which states must cover, most HCBS are optional  Medicaid benefits that states can cut when they face funding shortfalls.

The services that states provide in their HCBS programs vary, but they generally provide home health services plus help with chores, meals, transportation, and other services such as adult day care and respite care for family caregivers. Most states already limit HCBS due to funding constraints, and HCBS are a likely target if states must make substantial cuts due to federal funding shortfalls, because they spend more on optional HCBS than on any other optional benefit. The AHCA would therefore likely generate large increases in HCBS waiting lists.

 Read more on how the proposed fixed cap on per-beneficiary funding will result in reduced federal Medicaid payments to the states:


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