Challenges of Capping Medicaid Spending May 24, 2017 Capping Medicaid Spending May Prove Harder Than It Sounds for Senate Republicans – Modern Healthcare Modern Healthcare quoted Manatt’s Deborah Bachrach, a partner with Manatt Health, in an article about the difficulties of converting open-ended federal funding for all Medicaid beneficiaries into a system of capped payments to the states. Beyond the technical difficulties, the publication reports, there's another big reason that state officials, patient advocates and Medicaid experts are leery about a proposed capped-payment model. Once the framework is in place, Congress has a handy lever for braking spending, compared with the current system where spending is out of policymakers' control, determined by actual healthcare costs and the state of the economy. "Once we shift to a national trend rate, it's relatively easy for Congress in a bad budget year to hit the budget target by ratcheting down the rate," Bachrach explained.
