The Impact of the AHCA on Federal and State Medicaid Spending and Medicaid Coverage

The Impact of the AHCA on Federal and State Medicaid Spending and Medicaid Coverage

Passed by the U.S. House of Representatives in May, the American Health Care Act (AHCA) could result in as many as 14.8 million people losing Medicaid coverage, a report from the Urban Institute and the Robert Wood Johnson Foundation finds. The report, The Impact of the AHCA on Federal and State Medicaid Spending and Medicaid Coverage (24 pages, PDF), notes that by eliminating the 90 percent federal matching rate for Medicaid enrollees who gained coverage under the Affordable Care Act's Medicaid expansion, as well as introducing a per capita cap, the AHCA would give many states no choice but to end Medicaid expansion and further reduce enrollment to offset increased state spending on traditional Medicaid coverage. The analysis estimates that if all states were to drop the Medicaid expansion and further reduce enrollment, federal Medicaid spending could be cut by $938.3 billion, or 20.5 percent, over ten years, while state spending on Medicaid could drop by $78 billion over the same period. As a result, twelve million Medicaid expansion enrollees, or 20 percent of non-elderly enrollees, and an additional 2.8 million non-expansion enrollees, or a total of nearly a quarter of all non-elderly enrollees, would lose their coverage by 2022.