Letter to William A Hazel Jr., Secretary of Health and Human Resources - Trumpcare's Medicaid Cuts Will Have Significant Negative Impact on the Health of Vulnerable Virginians
Letter
Dear Dr. Hazel:
We write to you regarding the impact Medicaid per capita caps, like those in the American Health Care Act (H.R. 1628), would have on Virginia families. Medicaid, a joint state-federal partnership, provides efficient, affordable, responsive, and high-quality health care to a diverse population, including children, pregnant women, individuals with disabilities, and people aged 65 and older. Medicaid also plays an essential role in driving health innovation and delivery system reforms that allow individuals to receive care in community-based settings.
On May 24, 2017, the Congressional Budget Office (CBO) provided its estimate for H.R. 1628, and concluded that it would cut Medicaid by $834 billion over 10 years. A reduction of that magnitude or even one close to it-- especially to an already efficient program like Virginia's -- could have devastating effects. It is therefore essential that Virginians understand how a proposal of this nature would impact their access to care. To that end, we request responses to the following questions:
1) The AHCA could eliminate the requirement of the ten essential health benefits. How will this affect the public mental health safety net system as people lose behavioral health coverage through the marketplace?
2) In Virginia, Medicaid managed care organizations provide mental health benefits for members in support of their special health care needs. How will a per capita-based cap on Medicaid payments:
a. Impact those served in the public system, who suffer from chronic mental illness and substance use disorders?
b. Impact those with complex medical needs?
3) Virginia is under a U.S. Department of Justice Settlement Agreement that requires Virginia to develop a robust and integrated system of care, by increasing community-based services and adding more waiver funded slots over the next four years. The proposed per capita caps will significantly reduce Medicaid funding, which pays for these services. How will this impact Virginia's ability to remain compliant with the Settlement Agreement?
4) The creation of Medicaid waiver funded services (community supports) have enabled people with significant developmental disabilities to live with their families or near their families in community-based settings. What would be the impact of the reduction of funding on the community-based system?
I recognize that it may not be possible to completely answer all these questions, and in such cases would appreciate any analysis you are able to provide. Thank you for your timely attention to this request. If you have any additional questions, please contact our offices.
Sincerely,
Mark R. Warner Tim Kaine
United States Senator United States Senator
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