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Congressional budget office6/20/2023 Under the AHCA, beginning in 2020, Medicaid would transition to per capita cap to limit federal financing. Under current law, the federal government matches state Medicaid spending with no pre-set limit. Impose a Per Capita-Based Cap or Block Grant for Medicaid. New enrollees are covered at the traditional match rate. Reductions in spending for those covered at the enhanced match (those with coverage as of Decemwithout a break in coverage) as they cycle off the program (fewer than one-third of those enrolled as of Decemwould have maintained continuous eligibility two years later and the higher federal matching rate would apply for fewer than 5 percent of newly eligible enrollees by the end of 2024).Some states that have already expanded their Medicaid programs would not continue that coverage (some states might also begin to reduce coverage prior to 2020) and.No additional states will adopt the expansion resulting in 5 million fewer enrollees by 2026 compared to projections under current law.CBO estimates the following effects from this provision: Beginning in 2020, the AHCA would reduce the enhanced federal matching rate for newly eligible adults from 90 percent to the traditional match rate (which ranges from 50% to 75%) for those newly enrolled after December 31, 2019. Under current law, states that adopted the ACA Medicaid expansion receive an enhanced match rate for those newly eligible for coverage. Key Medicaid provisions include the following:įigure 1: CBO Estimates of Reductions in Federal Medicaid Spending in the American Health Care Act (AHCA) for Coverage ProvisionsĮnd of Enhanced Match for the ACA. Overall, the total uninsured would reach 51 million in 2026, or 23 million more than what is projected under current law with the ACA. Overall, the AHCA would reduce federal deficits by $119 billion over the 2017-2026 period with a number of provisions that increase costs and decrease revenues offset by large reductions in federal spending coming primarily from Medicaid and the elimination of subsidies for non-group health insurance included in the Affordable Care Act (ACA). By 2026, CBO estimates 14 million fewer people would be enrolled in Medicaid compared to current law. Most of the reduction in spending is tied to estimates of lower enrollment. By 2026, Medicaid spending would be about 24 percent less than what CBO projects under current law. American Health Care Act (AHCA)ĬBO estimates that the coverage provisions of the AHCA as passed by the House of Representatives would reduce direct spending for Medicaid by $834 billion over the 2017-2026 period (Figure 1). This data note reviews the Medicaid estimates included in the American Health Care Act as passed by the House of Representatives on prepared by the Congressional Budget Office (CBO) and staff at the Joint Committee on Taxation (JCT).
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