Blue states would lose the most funding under Republican health plan

A new analysis finds that blue states could lose a significant amount of federal funding for health care under the Graham-Cassidy bill.

The Kaiser Family Foundation estimates that if Graham-Cassidy becomes law, the federal government will spend $160 billion less from 2020 to 2026 to expand health insurance coverage, and 35 states plus the District of Columbia will face losses in federal funding.

Named for the two Republicans spearheading it - Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. - the bill is the latest effort by Senate Republicans to follow through on promises to repeal and replace Obamacare. The bill would redistribute federal funds that would have been used for Medicaid expansion or insurance subsidies. The funds would be given to states in the form of block grants, which Republicans say would give states enormous discretion on how to provide coverage.

But the Kaiser report shows that the redistribution is not equal.

New York, for example, stands to lose 35 percent of the money it currently receives from the federal government to subsidize health insurance and pay for Medicaid.

But Mississippi, the report estimates, could see a whopping 148 percent gain in federal funding under Graham-Cassidy. States that would see the largest increases in funding are states that chose not to expand Medicaid coverage under Obamacare.

Nonexpansion states, according to Kaiser, could gain a total of $73 billion, while Medicaid expansion states could lose $180 billion.

Next week the Senate will vote on Graham-Cassidy, and all eyes are on three senators who could decide its fate: Lisa Murkowski, R-Alaska; Susan Collins, R-Maine; and John McCain, R-Ariz. Under the legislation, Alaska and Arizona would face moderate losses in federal funding, while Maine, which did not expand Medicaid, would gain 8 percent in federal funding.

The five biggest losers in federal funding, percentagewise: New York (-35 percent), Oregon (-32 percent), Connecticut (-31 percent), Vermont (-31 percent) and Minnesota (-30 percent).

The biggest winners: Mississippi (148 percent), Texas (75 percent), Kansas (61 percent), Georgia (46 percent) and South Dakota (45 percent).

The large unknown that remains is what would happen in 2026, when block grants would end under Graham-Cassidy. Kaiser notes that if that block grants aren't renewed, funding would decrease by $240 billion in 2027 alone.

"Graham-Cassidy would be the biggest evolution of federal money and responsibility to states ever," said Larry Levitt of the Kaiser Family Foundation. "So until this passes, there's just no way to know what kinds of changes people face, because it will be different in every state."

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