NAMD Outlines Key Policy Considerations in ACA and Medicaid Discussions

The National Association of Medicaid Directors (NAMD) has developed two documents to assist federal policymakers and other key stakeholders as they engage in policy discussions around the role of Medicaid and the Affordable Care Act (ACA) in “the fabric of the current health care system.”  One is a list of considerations for the debate around the repeal of the Affordable Care Act and the other is a list of considerations for the debate around restructuring the underlying Medicaid program itself. NAMD points out that “any substantive changes to Medicaid’s financing structure must be done in close consideration of the complex and interconnected web of statutory and regulatory requirements,” arguing that “failure to do so could expose states to the greatest inter-governmental transfer of financial risk in the country’s history.”

State Medicaid Directors, according to a NAMD press release announcing the documents, “use every tool available to drive the program to be as effective and efficient as possible, to provide high quality services to those most in need, while being responsible stewards of the taxpayer dollar.” The “statutory levers that are necessary to influence this must come from the following areas: eligibility, payment, benefits, cost sharing, and administration,” and “outside of these key areas, change must come from fundamental reform of the underlying health care system, especially with respect to how care is delivered and how financial incentives are aligned.”

NAMD emphasizes that it “has not taken positions on proposals related to the ACA or structural changes to the Medicaid program.” Rather, “these resources seek to underscore important Medicaid considerations in such federal policy discussions.” However, NAMD does “request that the Trump Administration and congressional leaders form an expert workgroup of Medicaid Directors to provide technical expertise on any Medicaid proposals.”

FMI: The documents can be found at