Senior Policy Analyst
The Republican health plan that the House plans to consider on Thursday would force states to spend billions more to maintain their Medicaid programs (including the Affordable Care Act’s Medicaid expansion to low-income adults) or, far likelier, cut hundreds of thousands of low-income residents off Medicaid, most of whom would end up uninsured, according to projections by a growing number of state policymakers and independent researchers.
The House plan would cut the federal matching rate for each new expansion enrollee starting in 2020, effectively ending the expansion in the 31 states (plus the District of Columbia) that have adopted it. It also would impose a per capita cap on federal Medicaid funding for all of Medicaid. Combined, these changes would cut federal Medicaid spending by $880 billion over ten years and lower the number of Medicaid beneficiaries by 14 million in 2026, relative to current law, the Congressional Budget Office (CBO) estimates.
Among projections in individual states:
To make matters worse, two-thirds of states face revenue shortfalls this year or next, so they’d be even less likely to raise spending enough to offset the House Republican bill’s damaging Medicaid cuts.