Ed Kilgore for New York Magazine had an article explaining how TrumpCare’s “mean” cuts to Medicaid will affect health care spending.
According to the Congressional Budget Office, TrumpCare will cut Medicaid spending $834 billion over ten years. The federal share of costs would be “capped” at a particular level per enrollee, with a fixed annual “growth rate” (basically the medical inflation rate). The per capita cap reflects a long-standing GOP goal of ending Medicaid’s original status as an open-ended entitlement program in which the federal government would contribute a specified percentage of the costs incurred by states in covering eligible enrollees.
TrumpCare will also cut the Affordable Care Act’s federal subsidies for states (31 at this point) that choose to expand Medicaid eligibility to the universe of people (including able-bodied adults without children) with incomes under 138 percent of the federal poverty line.
‘Under ACA, the federal government initially covered 100 percent of the costs of covering the expansion population, a “super-match” that this year began declining toward a permanent level of 90 percent, still far above the usual match rate (which varies from state to state based on demographics, ranging from a minimum of 50 percent up into the 70s for a few really poor states). The House-passed AHCA would drop the super-match for new enrollees after 2020 (previous “expansion” enrollees would continue to receive the super-match so long as they had continuous coverage; in reality most would not meet that condition).”