DHCS Releases Analysis of Graham-Cassidy Proposal

The California Department of Health Care Services (DHCS), in collaboration with Covered California and the Department of Finance (DOF), released a preliminary analysis on the potential impact the Graham-Cassidy proposal would have on California. The analysis notes similar programmatic and fiscal concerns with previous Republican health care proposals, but notes the Graham-Cassidy proposal “is the most devastating of the three federal health care proposals” that DHCS has evaluated this year.

The DHCS analysis projects a massive cost shift from the federal government to states, resulting in nearly $4.4 billion in additional costs to California in 2020 and growing to $22.5 billion in 2026. The cumulative impact to California between 2020 and 2027 is expected to be $138.8 billion in federal funding cuts. DHCS highlights its most significant concerns with the Graham-Cassidy proposal, which include:

  • Shift in Medicaid federal financing to per-capita limit
  • Elimination of federal funding for Medicaid expansion
  • Time-limited state block grant program
  • Elimination of enhanced funding for IHSS

DHCS indicates the Graham-Cassidy proposal would result in a massive fiscal burden placed on the state, impacting not only the Medi-Cal program, but the larger health care delivery system on which all Californians rely. Should the Graham-Cassidy proposal become law, California will be faced with tens of billions of dollars in new costs and forced to make critical decisions regarding the populations and benefits covered.  The DHCS analysis overview is available here and the 2020-2027 analysis is available here.