The National Association of Medicaid Directors yesterday urged Congress to “carefully consider the significant challenges” posed by the Graham-Cassidy proposal. Unveiled last week by Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI), the legislative proposal would repeal components of the Affordable Care Act, make significant changes to how the Medicaid program is financed, and create a new grant program allowing states flexibility to design their own system to provide health care coverage and access to care. “Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history,” said NAMD, which represents Medicaid directors from all 50 states. “…Any effort of this magnitude needs thorough discussion, examination and analysis, and should not be rushed through without proper deliberation.” AHA also voiced opposition this week to the Graham-Cassidy proposal, which Senate Majority Leader Mitch McConnell (R-KY) plans to bring to the floor next week.