The Klondike Kickback: How the Senate Health Care Bill Screws Blue States on Medicaid While Sparing Alaska – Slate Magazine (blog)

So they’ve added a caveat. On page 64 of the bill, it says that if a state spends 25 percent more than average per patient, Washington will reduce its Medicaid contribution by up to 2 percent the next year. (So, if were scheduled to grow by 2.4 percent, it might only grow by .4 percent). If a state spends 25 percent less than average, it will see its contribution increased by 2 percent. Essentially, states—including much of the Northeast—would be penalized for being generous, in order to fund more Medicaid spending in states that are not. It’s only a one-year penalty—so it’s not designed to ratchet down funding for, say, New York or Massachusetts over time. But “it really is hurting states that, for a variety of reasons, have higher spending per beneficiary,” Edwin Park of the Center on Budget and Policy Priorities told me.*

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