Graham-Cassidy Co-Sponsor’s State Gets Special Medicaid Carve-Out

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September 21, 2017 4:48 p.m.

WASHINGTON (AP) — An inscrutably written provision in the Republican health care bill would steer extra federal cash to Wisconsin, home state of one of the measure’s co-sponsors, according to health care analysts who’ve examined the legislation.

The language could mean “potentially hundreds of millions” of extra dollars for Wisconsin, said April Grady, a health care consultant. She and other analysts said they were not aware of other states that would benefit from the provision.

Sen. Ron Johnson, R-Wis., is one of the co-sponsors of the health care overhaul that Republican leaders hope to push through the Senate next week.

The measure, the GOP’s final push to repeal much of President Barack Obama’s health care overhaul, would end its Medicaid expansion and subsidies for people buying private insurance and combine the money into new block grants for states. Its fate is uncertain.

The bill was chiefly written by GOP Sens. Bill Cassidy of Louisiana and South Carolina’s Lindsey Graham, and it’s filled with provisions making some states winners and others losers. Generally, the measure would shift money from states that expanded their Medicaid programs for the poor under Obama’s statute, which tend to be run by Democrats, to the largely Republican-run states that shunned that expansion.

In a written statement provided by aides, Johnson said funding formulas to correct “the grossly unfair” distribution of money under Obama’s law needed to be changed “to reflect the unique circumstances of many states, including recognizing the innovative reforms of Wisconsin.”

The provision does not mention Wisconsin by name. But it lets some states that turned down extra federal funds to expand Medicaid to count the rejected money in a formula determining how large a state’s newly created block grant will be.

Wisconsin is among 19 states that declined to fully expand Medicaid under Obama’s law, which also provided generous federal reimbursements. Under Gov. Scott Walker, a GOP 2016 presidential contender, Wisconsin just partially expanded Medicaid and agreed to accept smaller federal subsidies.

The provision in the health care bill applies to states that expanded Medicaid only up to 100 percent of the federal poverty level and had that expansion in effect this past Sept. 1.

“As far as we can tell, the only state it’s applicable to is Wisconsin,” said Robin Rudwitz, a Medicaid analyst for the nonpartisan Kaiser Family Foundation.

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