Get the Facts: Here's who has Medicaid, what impact budget cuts could have
Find out how the proposed Medicaid budget cuts could affect millions of enrollees and the health centers they rely on
Find out how the proposed Medicaid budget cuts could affect millions of enrollees and the health centers they rely on
Find out how the proposed Medicaid budget cuts could affect millions of enrollees and the health centers they rely on
The House of Representatives last week passed a Republican budget proposal that calls for $2 trillion in spending cuts. This includes at least $880 billion in mandatory spending cuts on programs of the House Energy and Commerce Committee, which oversees Medicaid. While it鈥檚 unclear where those cuts would come from, speculation is that Medicaid could see a reduction.
Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. This includes eligible low-income adults, children, pregnant women, people 65 and older and people with disabilities.
Meanwhile, Medicaid expansion is a provision of the Affordable Care Act (ACA) that allows states to expand coverage for adults with incomes up to 138% of the federal poverty level. Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming have not adopted the Medicaid expansion.
More than 79 million people were enrolled in Medicaid and the related Children's Health Insurance Program (CHIP) as of October 2024, according to government data.
If all states drop the Medicaid expansion, resulting in changes to enrollment as well as total federal and state spending, then around 20 million people could lose coverage, based on a health policy by the Kaiser Family Foundation.
At least one in five people in each state are enrolled in Medicaid and CHIP, and all states rely on federal matching funds to support these health programs.
In states that have , people can qualify based on income alone, and if their household income is below 133% of the federal poverty level, they are eligible for Medicaid.
This Medicaid expansion is a ballot measure that people voted on. For 12 of these states, legislative triggers are set to drop Medicaid expansion if the enhanced Federal Medical Assistance Percentage (FMAP) is lowered. These states include Arizona, Arkansas, Idaho, Illinois, Indiana, Iowa, Montana, New Hampshire, New Mexico, North Carolina, Utah and Virginia.
Wil Franklin, the CEO of a federally qualified health center/community health center in Kansas City, Missouri, said roughly 30% of the 20,000 patients that they serve are covered by Medicaid.
鈥淸For] a lot of Missouri health centers, the primary source of revenue is Medicaid. Well, that's also even when you think about federal grants, sometimes the community health centers get. The reality is, most of those don't even cover 20% of the overall cost,鈥� said Franklin.
The federal government currently pays for 90% of the cost of Medicaid for enrollees who qualify under Medicaid expansion in Missouri. This means Missouri鈥檚 budget will take a hit if Congress ends the 90% match to Medicaid expansion states.
鈥淔rom a budgeting standpoint here locally, you know, we're just trying to look at, you know, scenario A, scenario B, scenario C, and really trying to operate and control as many of the variables that we can,鈥� said Franklin. 鈥淲e can't always change everyone's minds in Congress, but we can work really hard because a lot of their constituents are our patients.鈥�