CHA News Article

Issue Brief Explains States at Greatest Risk From Medicaid Cuts, Caps

The Kaiser Family Foundation has released the attached issue brief analyzing which states are most at risk from the American Health Care Act (AHCA) proposal to end enhanced federal matching funds for Medicaid expansion, established as part of the Affordable Care Act (ACA). The proposal would cap – and significantly reduce – the amount of federal funding states receive for Medicaid through a per capita cap or block grant. According to the Congressional Budget Office, the AHCA as passed by the House would reduce federal Medicaid spending by $834 billion from 2017-26, and reduce enrollment by 14 million by 2026; the Trump Administration’s proposed budget would further reduce Medicaid spending. While all states would face challenges related to these cuts, states with limited Medicaid programs, poor health status, high cost markets or low state fiscal capacity would have the most difficulty responding to per capita cap or block grant policies. The brief finds that in states that expanded Medicaid coverage post-ACA, such as California, a scaling back or elimination of expansion coverage is likely.