Changes to Medicaid Expansion in the American Health Care Act

State-by-State Estimates of the Coverage and Fiscal Impact

The House currently is considering the American Health Care Act (AHCA), a bill to repeal and replace the Affordable Care Act (ACA). Among other things, the bill will phase out enhanced federal funding for the expansion of Medicaid to low-income adults with incomes below 138 percent of the federal poverty level. Currently, more than 14 million low-income parents and adults without children are covered under expansion in 32 states, including the District of Columbia. The remaining 19 states have not yet expanded Medicaid and would be precluded from receiving enhanced federal funding to do so under the AHCA.

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In a new analysis, Manatt Health provides state-by-state estimates of the impact of the loss of enhanced federal funding on coverage and federal Medicaid expenditures in expansion states.  The analysis is based on state-level projections of Medicaid spending and enrollment developed by Manatt Health and shows the expected fiscal and coverage effects for each state assuming it continues coverage expansion just for those adults for whom enhanced federal funding is available.