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What If Ryan’s Medicaid Block Grant Were Already in Effect?


As I pointed out last week, the Congressional Budget Office has found that House Budget Committee Chairman Paul Ryan’s proposal to block-grant Medicaid would significantly shift costs to states, beneficiaries, and health care providers.  To help illustrate how states would likely fare under the proposal over time, we compared how much federal funding they would have received under the block grant for fiscal years 2000 through 2009 to what they actually received (excluding the temporary increases provided during recessions).   We found that the Ryan block grant would have cut federal Medicaid funds to most states by more than 25 percent by 2009 and to several of them by more than 40 percent.

Every state would have received substantially less from the federal government than it actually received, but some states would have received much, much less.  Our findings show that:

  • States would have received $350 billion — or 21 percent — less over the ten-year period than they actually did.
  • In 2009 alone, the cuts in federal funding would have equaled an estimated $63.5 billion, a reduction of 29 percent.
  • While the Ryan block grant would have hit all states hard over the ten-year period, it would have produced disparate effects, with some states made substantially worse off than others.

State-by-state figures are available here.