Building off the latest analysis from the Congressional Budget Office on the House-approved American Health Care Act, a new report from the Urban Institute and Robert Woods Johnson Foundation found that federal Medicaid spending could fall by $938.3 billion, or 20.5 percent, from 2019 to 2028.
State spending is estimated to decrease by $78 billion over the same period under the AHCA.
However, the report also found that large cuts to Medicaid funding would lead to 14.8 million people losing Medicaid benefits.
Researchers analyzed federal and state spending, as well as the number of people who stand to lose coverage in all 50 states. They considered three scenarios:
- States preserve Medicaid expansion by upping their own spending or by cutting benefits or provider payment rates to offset federal cuts
- States roll back Medicaid expansion but increase spending for other enrollees to offset per capita caps and other federal cuts
- States further cut Medicaid enrollment to compensate for other AHCA changes to the program
If current Medicaid eligibility requirements stay the same between 2019 and 2028, researchers estimate the AHCA would reduce federal Medicaid spending by $373.6 billion, or 8.2 percent. If all states eliminated coverage for their Medicaid expansion populations, federal spending would fall by as much as $803.2 billion, or 17.5 percent, over the 10-year period. At this rate, an estimated 12 million people would lose coverage.