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The federal–state Medicaid program is facing the possibility of the largest and most consequential changes to its funding since its inception in 1965. The American Health Care Act (AHCA), H.R. 1628, as adopted by the House of Representatives on May 4, would replace the current federal matching program for Medicaid with a per capita cap on federal funds. This cap would limit the growth of these funds to the growth rate of the medical care component of the Consumer Price Index, with an additional 1% growth allowed for older adult and disabled Medicaid enrollees. The Congressional Budget Office has projected that this policy would result in federal funding reductions of more than $800 billion over the next 10 years, equivalent to a 26% reduction in federal support by 2026. These large reductions represent an unprecedented shift of financial risk to the states. Missing from the debate has been consideration of policies that could improve the value of the Medicaid program, controlling Medicaid spending without diminishing coverage or quality. (K. John McConnell and Michael E. Chernew, 6/14)

The congressional Republican proposal to establish a budget cap on federal Medicaid spending has raised alarms among healthcare industry leaders, state policymakers and patient advocacy groups. The American Medical Association came out firmly against Medicaid spending caps Tuesday, with one AMA board member calling the GOP proposal "disastrous for patients." (Harris Meyer, 6/15)

While the media fixates on Trump, Republicans are rushing through legislation that will deprive millions of Americans of health insurance coverage and open the way for another Wall Street wilding... Millions of Americans — particularly older workers, the aged and the mothers and children who depend on Medicaid, the disabled and the vulnerable — are about to be stripped of health-care coverage. (Katrina Vanden Heuvel, 6/15)

Medicaid has been around for decades. It doesn’t grab headlines like the Affordable Care Act. It can be boring. It’s also terribly important for children’s health. And healthy children are key to our state’s future prosperity. Thanks to the hard work of many, 96 percent of all N.C. children have health insurance. A little under half of those insured are covered by Medicaid – the workhorse of health coverage. (W. Scott St. Clair, 6/15)

Recently, a patient with end-stage kidney disease told me that his insurance company stopped covering one of his essential medications. It took me hours of phone calls to reinstate this lifesaving treatment. Another patient — frail and elderly — was on the verge of having to move to a nursing home. An intensive blitz to coordinate visiting nurse services, physical therapy, Meals on Wheels and home hospice allowed her to stay in her home. Advocating for patients is as much a part of medical care as the medical care itself. (Danielle Ofri, 6/16)

Anyone who thinks real compassion is found in a federal government program hasn’t spent much time at the post office. That’s the central insight motivating the inclusion of the state waiver from the Obamacare program in the House-passed American Health Care Act. And it’s the reason President Trump was wrong to call the bill “mean.” Almost everyone is frustrated with the process of repealing and replacing Obamacare that has played out this year. Conservatives are most justified in their frustration. After consistently being told the Republican Party was unified in the objective of repealing Obamacare lock, stock and barrel, we’ve had our worst suspicions confirmed about the cynicism of so many in Washington. (Michael Needham, 6/15)

Right now, the Republican leadership in the Senate is undertaking an unprecedented effort to write and pass a bill to remake the entire American health-care system in secret, with not a single hearing or committee markup and with its details kept hidden even from many Republican senators. This plan was devised by Senate Majority Leader Mitch McConnell (Ky.), who is widely respected for his strategic acumen even by Democrats who believe he has a bottomless void where his soul ought to be. But is it possible that McConnell’s plan will backfire? (Paul Waldman, 6/15)

Insurers must submit applications by next Wednesday to sell plans through HealthCare.gov, and these will give us some of the first indicators of how high ObamaCare costs will skyrocket in 2018. ObamaCare supporters can’t wait to blame the coming premium increases on the “uncertainty” caused by President Trump. But insurers faced the same uncertainty last year under President Obama. (Chris Jacobs, 6/15)

Is there a right to health care? As much as people argue about it, it’s not a very good question — not, at least, in our society, in which nearly everyone agrees that all people must have access to some basic level of health care. Because of that consensus, conservatives who deny a right to health care don’t really mean it, and liberals who affirm it can’t use it to clinch the case for their favored policies. (Ramesh Ponnuru, 6/15)