Key Point: “Cutting Medicaid spending, which is central to the budget bill that House Republicans may bring to a vote on Tuesday, could result in millions of Americans across the country losing health coverage … If states picked up the costs from the federal government and kept their expansion populations in place, they would spend more than $600 billion to do so over a decade, an increase of almost 20 percent, according to KFF. Many states would be short more than $10 billion over a decade, and some larger states, such as New York and California, would face a shortfall of more than $50 billion.” 

New York Times: As G.O.P. Eyes Medicaid Cuts, States Could be Left With Vast Shortfalls

By Noah Weiland and Sarah Kliff

• Cutting Medicaid spending, which is central to the budget bill that House Republicans may bring to a vote on Tuesday, could result in millions of Americans across the country losing health coverage unless states decide to play a bigger role in its funding.

• More than 70 percent of Americans say they want Medicaid to stay as it is, according to a survey conducted last year by KFF, a nonprofit health policy research group.

• Jon Tester, the former Democratic senator from Montana, said that Medicaid cuts could have a more sweeping effect on rural America than urban areas because of how the program sustains impoverished areas with few health providers. “And that’s an interesting conundrum because most of rural America is a much deeper red than urban America,” he said.

• “If you take away health care, you can’t live there,” Mr. Tester said.

• If states picked up the costs from the federal government and kept their expansion populations in place, they would spend more than $600 billion to do so over a decade, an increase of almost 20 percent, according to KFF. Many states would be short more than $10 billion over a decade, and some larger states, such as New York and California, would face a shortfall of more than $50 billion.

• With Montana’s expansion program set to expire in June, a group of state lawmakers there advanced legislation last week that would extend the program, in part to keep health providers in the heavily rural state solvent. Roughly 80,000 people in the state now have coverage through the state’s expansion, drastically lowering the state’s uninsured rate.

• In Illinois, another state with a trigger law, roughly a quarter of the state’s Medicaid program is part of the expansion population, and the state’s uninsured rate dropped by 44 percent after the expansion took effect, said Alex Gough, a spokesman for Gov. JB Pritzker, a Democrat. The state receives more than $7 billion for that group, Mr. Gough added.

• “Threats to coverage would spell catastrophe,” he said. He added that eliminating the Medicaid expansion “would cause major disruption to the state’s health care infrastructure that relies on Medicaid funding and, ultimately, its economy.”