The GCHJ shifts the current system of federal healthcare funding to a block grant system that gives states money up front in a large lump sum. The current system matches a percentage of each state’s actual spending to ensure it grows along with expenditures.
The bill would also change the formula to determine how much each state receives from the federal government. The idea, as the authors have put it, is not to favour those states that decided to expand Medicaid under Obamacare.
This does, however, lead to a distinct separation of winners and losers under the bill.
The Center on Budget and Policy Priorities broke down just how much states would gain or lose in federal funding through 2026 under GCHJ. The biggest loser would be California, with $US27.8 billion of funding shaved off over the timeframe. This biggest winner is Texas, which would receive an additional $US8.2 billion. In total, federal funding would decrease by $US80 billion through 2026.
Here’s a breakdown of the winners and losers in map form:
Perhaps most interestingly, in the political sense, is the fact that three of the losers from GCHJ are Arizona, Maine, and Alaska.
GOP Sens. John McCain, Susan Collins, and Lisa Murkowski were the three deciding votes on the first GOP healthcare push and hail from those three states. The issue for Collins and Murkowski with the first Senate Obamacare repeal bill was the amount of money the plan took away from their state, which seems to also apply here.
McCain also emphasised that the bill would need to be beneficial for Arizona, and said he would prefer if the bill went through the normal committee process — which the GCHJ is not.
Given that Sen. Rand Paul came out against the bill on Friday, only one of those three senators could vote against the bill for it to pass. Other wildcard Republican senators in states that lose money, like Shelley Moore Capito in West Virginia, could throw a wrench in the plan.
Republicans ability to pass the bill under budget reconciliation, which avoids a Democratic filibuster, runs out at the end of September.
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