WASHINGTON —As the president’s Affordable Care Act health care law moves closer to implementation, Rep. Bill Cassidy, R-Baton Rouge, on Tuesday filed his legislation to attempt to create more financial and efficiency accountability for Medicaid funding.
Cassidy is pushing his tweaked Medical Accountability and Care Act — the first version died in Congress last year — as a way that he contends will more fairly allocate funding to states in a “per capita” way while reining in overall Medicaid spending, which he argues is out of control.
A physician by trade who worked for decades at a public hospital, Cassidy said he for too long saw patients treated as “flotsam and jetsam” with long lines and not enough adequate medical resources to give many of them proper care.
In the wake of a Republican-led “Making Medicaid Work” congressional report that was released last week, Cassidy said it adopted a lot of his ideas and makes it possible for his MAC Act to become part of any kind of deficit reduction “grand bargain.”
“The last time Medicaid was updated, the Beatles were the most popular band in America and we were still half a decade away from walking on the moon,” Cassidy said in his announcement. “It’s time to modernize the way Medicaid is financed and incentivize better care thus improving Medicaid’s bottom line and patient outcomes. If nothing is done, the status quo will eventually bankrupt Medicaid and America.”
Cassidy’s MAC Act would reduce Louisiana’s — and other states’ — share of the Medicaid health-care funding for the nation’s poor.
Medicaid is the government health insurance program for the poor and is paid with federal and state dollars.
Gov. Bobby Jindal has rejected the Medicaid expansion that is part of the Affordable Care Act, called Obamacare, claiming it will be too costly over time and that its basis is a broken health care system.
Cassidy prefers the MAC Act as a type of “per capita cap” system that he believes can draw more bipartisan support than the type of “block-grant” Medicaid system for states pushed by some Republicans and also entice more doctors to participate. He said he wants to change Medicaid financing so states will not be able to just use the federal government as a “blank check” for matching funds.
Instead, Cassidy said, the bill proposes distributing funds on a per-capita basis to states based on the number of Medicaid enrollees in four categories: the elderly, blind or disabled, children and adults. Louisiana, for instance, has a lot more disabled patients while a state like Vermont has a lot more elderly ones.
Cassidy’s bill would, over a 10-year phase-in period, adjust federal payments so states could only receive within 10 percent of the national average of what is received per capita.