Vice President for Health Policy
The Senate health bill’s Medicaid cuts would deepen significantly in the second decade, the Congressional Budget Office estimated today, growing from 26 percent in 2026 to 35 percent in 2036, relative to current law (see graph)
Consequently, CBO states “enrollment in Medicaid would continue to fall relative to what would happen under” current law.
CBO previously estimated that the bill, which would effectively end the Affordable Care Act’s Medicaid expansion and convert Medicaid to a per capita cap, would cut federal Medicaid spending by $772 billion over the first decade and reduce enrollment by 15 million by 2026.
Over the long run, the Senate bill would cut Medicaid more than the House bill because it lowers the growth rate for federal funding under the per capita cap below even the House bill’s inadequate level starting in 2025. That’s why CBO estimates the Senate bill’s cut in 2026, $160 billion or 26 percent, to be larger than the House bill’s — even though the Senate bill ends the enhanced federal funding for the Medicaid expansion more gradually. As a result, Medicaid enrollment would fall by 1 million more than under the House bill in 2026.
In 2035, federal Medicaid spending would equal 1.6 percent of gross domestic product (GDP) under the Senate bill, CBO estimates, compared to 2.4 percent under current law.