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Urban Institute Details State Impact of AHCA Cuts

The American Health Care Act (AHCA) would cut federal and state Medicaid spending by $734 billion over 10 years, with 57 percent of that reduction coming from a repeal of Medicaid expansion, the Urban Institute said in a recent report.

The remaining 43 percent of the cut would result from AHCA provisions that would impose per-capita caps on federal Medicaid funding, the Institute said.

The report projects that federal funding would decline by $457 billion from 2019 to 2028 and an additional $277 billion through proportional cuts in state contributions, or $734 billion overall. States would have to increase spending by 16.1 percent during that period to compensate for the lost federal funding.

Federal spending cuts would fall heavily on low-income expansion states, such as Kentucky, West Virginia, Montana, New Mexico, and Oregon. If all expansion states (except those that expanded coverage to childless adults before the ACA) dropped coverage for the expansion population, an estimated 8 million people would lose Medicaid coverage in 2028, the Institute said.

For questions, please contact Shawn Gremminger, director of legislative affairs, at 202.585.0112 or


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

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