Proposals to shift some health care administration from the federal government to the states might limit some coverage under Medicaid. Individuals who receive coverage under more than one government plan could also be affected.
Consider that more than 8 million military veterans receive care from the Veterans Health Administration (VHA). A portion of those veterans receive dual coverage under other government plans from the Department of Defense, Medicaid or Medicare. Dramatic changes to Medicaid or the ACA coverage could return some veterans solely to VHA coverage, placing a greater burden on the system. Veterans in rural areas could be particularly affected, since they often must travel greater distances to a VHA hospital.
“Veterans in rural areas make up a disproportionate number of veterans who receive VHA care. If the repeal of the ACA takes away these veterans’ additional coverage, how will this impact the care that they need to receive?” said Stacy Tselekis
, principal in the Public Sector practice.
Another concern is whether the repeal and replacement of the ACA will mean that the federal government is going to have to develop a whole new system of processes and controls to ensure compliance and measure performance outcomes.
“A change in the ACA will impact the Centers for Medicare and Medicaid Services as they will need to support the system overhaul contemplated by the new administration,” said Sharif Ambrose
, principal in Grant Thornton’s Public Sector practice. “With the implementation of the ACA, several adjustments were needed before the enrollment website was working effectively. Is a repeal or replace going to mean overall changes to the enrollment systems, and will the time required to implement these changes take longer than most expect?”