Fitch: Governors voice bipartisan concern over federal healthcare policy changes
Expansion states face fiscal and policy issues, while non-expansion states could be forced to increase charity funding and high-risk pools.
State executive budgets reveal that Democratic and Republican governors and legislative leaders are concerned about the far-reaching effects of anticipated changes to federal healthcare policy under the Trump administration, according to a new Fitch Ratings report.
Many state leaders have said that the expected policy changes -- chief among them repeal of the Affordable Care Act -- would have a substantial effect on their budgets. States have the power to adjust, the report said, but success depends on what action the federal government takes.
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"Significant federal changes are likely, fundamentally altering federal healthcare policy and requiring substantial fiscal and policy shifts by states," said Fitch Director Eric Kim in a statement.
Both Medicaid expansion and non-expansion states face challenges under a potential repeal of ACA. Expansion states face fiscal and policy issues, while non-expansion states could be forced to increase charity funding and support high-risk insurance pools if the state exchanges are upended.
Local governments also face risks, notably reduced K-12 funding, revenue-sharing programs, and social service support due to over-extended state healthcare funding responsibilities. They may also be forced to assume higher Medicaid, healthcare facility and retiree healthcare costs.
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