Bob Atlas Quoted in “2018 Outlook: Uncertainty Continues to Cloud Managed Medicaid Market”

AIS Health

Bob Atlas, a Strategic Advisor and President of EBG Advisors, Inc., in the firm’s Washington, DC, office, was quoted in AIS Health, in “2018 Outlook: Uncertainty Continues to Cloud Managed Medicaid Market,” by Lauren Flynn Kelly.

Following is an excerpt:

The start of 2017 contained vast uncertainty for Medicaid stakeholders, as a president intent on repealing and replacing the Affordable Care Act (ACA) assumed control of the White House and the GOP counted implementing block grants and doing away with Medicaid expansion among their many health care reform goals. One could say the same uncertainty hangs over the program a year later, although industry experts interviewed for AIS Health’s annual Outlook Survey point out that what did and did not happen last year may provide a clearer view of things to come for managed Medicaid plans in 2018 and beyond. …

Bob Atlas, president of the EBG Advisors consulting unit of health care law firm Epstein, Becker & Green, points out that of the 4 million projected by the CBO to be uninsured the first year in which the law takes effect, 1 million would have been on Medicaid, and 5 million fewer will be on Medicaid in 2027. “Medicaid is implicated because when people in fulfilling their obligations under the mandate go to sign up, many of them discover they are eligible for Medicaid and by law are steered in that direction,” he explains. “So, if fewer uninsured people are going through the enhanced process of seeking coverage, fewer are going to end up on Medicaid.”

Will More States Expand Medicaid?

With enhanced FMAP funding intact for the foreseeable future, another wild card is whether states that did not expand will seek to do so, adds Atlas. Maine in its November 2017 election passed a referendum to expand Medicaid, although Gov. Paul LePage (R), who thwarted the legislature’s attempts to enact Medicaid expansion, has demanded that the legislature first find a way to pay the state’s share.

Meanwhile, Virginia Governor-elect Ralph Northam (D) intends to pursue expansion efforts despite the state legislature’s repeated opposition to proposals from Gov. Terry McAuliffe (D). The fate of expansion there hangs on a deadlocked House of Delegates race that at press time was unresolved. The outcome could result in a legislature equally comprised of Democrats and Republicans.

The new tax law also limits the deductibility of state and local income and property taxes at $10,000 per household per year, which could put states having higher taxes under pressure from their taxpayers to lower such taxes, observes Atlas. This could place additional financial strain on state Medicaid budgets, he suggests.