Should the Federal Gov’t Help States Expand Medicaid Coverage Under the ACA? (H.R. 909)
Do you support or oppose this bill?
What is H.R. 909?
(Updated February 18, 2021)
This bill would amend Medicaid to provide the enhanced federal medical assistance percentage (FMAP) to every state that expands Medicaid coverage for individuals who are newly eligible under the Patient Protection and Affordable Care Act (aka Obamacare), regardless of when the expansion takes place. Under the current law, the enhanced FMAP is equivalent to 100 percent in 2014-2016, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent thereafter. This bill retains this enhanced FMAP, but bases it on a term of calendar quarters rather than calendar years.
This bill would apply retroactively.
Argument in favor
The Medicaid Pay Parity program increased Medicaid provider reimbursement to match Medicare provider reimbursement, helping states expand Medicaid access after Obamacare’s enactment. Restoring this program will help states’ Medicaid programs pay healthcare providers.
Argument opposed
Many states have already extended Medicaid pay parity of their own accord, making this bill unnecessary. States that haven’t done so had plenty of time to expand Medicaid when the federal government would’ve helped offset more of the cost.
Impact
Medicaid; states; ACA; and the Social Security Act.
Cost of H.R. 909
A CBO cost estimate is unavailable.
Additional Info
In-Depth: Rep. John Lewis (D-GA) reintroduced this bill from the 115th Congress to restore the Medicaid Pay Parity program, which expired on December 31, 2014.
In October 2014, the American Academy of Family Physicians (AAFP), American College of Physicians (ACP), American Osteopathic Association (AOA), and the American Academy of Pediatrics (AAP) supported extending payment parity for at least the 2014-2016 period. At that time, AAFP president Robert Wergin, MD FAAFP said:
“Without Congressional action to extend Medicaid parity with Medicare, primary care physicians will see an abrupt cut to Medicaid payments for the care they provide to low-income families. This could wipe out the progress of ensuring that low-income Americans have access to primary medical care. We know from research that when Medicaid beneficiaries cannot find a physician who accepts new Medicaid patients, they face the same access problems as those who have no insurance.”
This bill has two cosponsors, both of whom are Democrats, in the current session of Congress. Last Congress, this bill had no cosponsors and didn’t receive a committee vote. Rep. Lewis first introduced this bill in 2014, as the Medicaid Parity Act of 2014 (H.R. 5353).
Of Note: The Medicaid Pay Parity program was a provision outlined within the Affordable Care Act. It increased Medicaid provider reimbursement to match that of Medicare providers. It expired on December 31, 2014 and wasn’t extended nationally.
However, some states have chosen to continue Medicaid pay parity. Alabama, Colorado, Iowa, Maryland, Mississippi, and New Mexico have extended Medicaid pay parity. Alaska is paying doctors even more than the Medicare rate. A few other states — Connecticut, Delaware, Hawaii, Maine, Michigan, Nebraska, Nevada, and South Carolina — have chosen to increase Medicaid reimbursement, but not to the full Medicare rate.
Media:
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American Academy of Pediatrics Letter (In Support, 2014)
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Medical Economics (Context, 2014)
Summary by Lorelei Yang
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