Friday, October 6, 2017

"John Faso's Philosophical Conundrum" Letter to the Editor Tom Denton

With the collapse of the Graham/Cassidy bill, Congressman John Faso just dodged a bullet. He has long railed against the State of New York’s transfer of Medicaid obligations to localities, calling it Nelson Rockefeller’s “51-year-old mistake.”  In July the House AHCA bill passed with a special amendment (tailored to Faso’s request) that denied federal funds to New York if it didn’t rescind its requirement of a county share for Medicaid.

The National Association of Medicaid Directors, declaring its members “strong proponents of state innovation in the drive towards health care system transformation,” nevertheless asserted the following:  “the per-capita caps and the envisioned block grant [of the proposed Graham/Cassidy legislation] would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history.”  It concluded by urging Congress to “revisit comprehensive Medicaid reform” with more “careful consideration.”


Some Senate Republicans claim that in the future they will continue to push ACA repeal and replacement with the Graham/Cassidy concept of block grants to states.  If this GOP policy goal persists and the House initiates new legislation around state block grants, Rep. Faso will have to explain to his constituents whether what’s good for the goose is good for the gander.  Will he profess outrage about unfunded mandates and New York State’s Medicaid requirements for counties but find it acceptable for Uncle Sam to dump Medicaid in the lap of the 50 states with massively reduced funding?  Remember his vote on the AHCA bill and stay tuned.

Publishing history
Kingston Freeman      10/1

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