Brief Summary of the Senate’s Approach to the AHCA (or Health Care 2.0)

June 08, 2017

The Senate outline – it isn’t a bill yet – includes tax credits, elimination or reduction of the Medicaid Expansion in states where that was chosen, protection for individuals with pre-existing conditions and elimination of the mandate for essential health benefits.  Some small part better than the House version!

The Per Capita Cap on Medicaid – which is our greatest concern – is still in the plan; it would be passed on a three part formula:

  • 2016 expenditures per enrollee

  • The number of disabled individuals (I have no further definition of that)

  • A growth factor based upon CPI + 1%


There is a lot of discussion among factions in the Senate about the “growth rate;” clearly we advocate for it to be at least CPI +1%; we are also arguing that any reduction in Medicaid (Virginia estimates) will immediately result in an increase to the Waiting Lists and potential expansion of institutional populations in direct contrast to the Olmstead requirements!

Most worrisome is the speed that Senate Majority Leader McConnell wants to move this through the Senate!