Proposed Medicaid Funding Cuts Threaten 20 Million Enrollees

Republican lawmakers in Congress are considering significant cuts to Medicaid, potentially impacting coverage for up to 20 million people. A proposal under discussion would reduce the federal funding match for states that expanded Medicaid under the Affordable Care Act (ACA) from 90% to lower percentages, which could lead to states facing a $626 billion funding shortfall over a decade. An analysis from KFF indicates that if all states maintain their Medicaid expansions, federal Medicaid spending could decrease by 10%, while states would need to increase their spending by the same amount. However, if states do not compensate for the lost federal funds, the overall Medicaid spending could drop by $1.9 trillion over ten years. Currently, 40 states and the District of Columbia have expanded Medicaid, but nine states have laws that would terminate expansions if federal funding decreases. Amidst these discussions, some states are already moving to reduce Medicaid eligibility or repeal the expansions enacted under the ACA.