American Health Care Act, Title 1, Subtitle C – Per Capita Allotment for Medical Assistance (Medicaid)

If you are still reading this after seeing the title, you are an inspiration to me TUH-DAY! I hated to put it there but it’s mostly necessary so you know what this post is about. Overall, Subtitle C of the AHCA (American Health Care Act) bill was much easier to translate for you. It’s not so much because it was worded to be easily understood, but rather because I understood enough to realize that it mostly dealt with outlining formulas for how much should be spent on medical assistance per person (aka per capita).

The simplest summary is that it actually adds a new section to the Social Security Act, the legislation that actually governs Medicaid. The new section gives instructions calculating how much IS spent per person for Medicaid and how much SHOULD be spent. This will be different from year to year and from State to State. If a state exceeds how much should have been spent per person, the they will receive less money each quarter for the next year. In other words, if they overspend by $100,000, they will receive $25,000 less in Medicaid allotments every three months the following year.

I assume this is done to not only discourage overspending but also for the Federal government to recoup the excess money spent. There are a few exemptions and adjustments for money spent for things like payments to hospitals that serve an unusually high number of low-income families and payments for Medicare cost-sharing. Having budget targets are definitely a good thing in my opinion! After all, don’t we have to do the same thing in our own homes? If we go over budget in one category, we have to pay it back over time via credit payments or borrow it from another area. Only time will tell, however, if a mandate such as this will work in places like Michigan where the Flint water crisis has caused widespread health issues. As part of the response, they have created a super-sized expansion of sorts where some residents of Flint can apply for assistance¬†even if they earn up to four times of the poverty level income. Sure, this is a special case but it is a good example of a community that has wide-spread health issues and need for specialty care. If these types of cases can be dealt with individually, then I think this could be a good step forward to controlling the national budget.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s