State-specific impact estimates of American Health Care Act

A new analysis by the Urban Institute finds that per capita caps on federal Medicaid spending under the American Health Care Act (AHCA) would reduce federal Medicaid funding to states by $457 billion or 9.8% from 2019 through 2028. If states increase spending to fully offset the loss of federal funds, it would increase states’ Medicaid costs by 16.1%. States in the ERC region will lose a total of $144 billion from 2019 to 2028. New Jersey will lose 20.6%, the most among ERC states as a share of federal funding. The authors project that use of the AHCA’s proposed trend factor will disadvantage children and adult Medicaid categories most. The analysis models the impact of the AHCA as originally proposed. The bill is being negotiated in the House as of this writing. State-specific fact sheets are available here.

Medicaid per capita cap impact on federal funding, 2019 to 2028 (billions $)
ACA (Current law) AHCA spending difference % change
CT 65 58 -7 -10.9%
DE 16 14 -2 -15.0%
ME 23 22 -1 -3.9%
MD 84 70 -14 -16.3%
MA 113 100 -13 -11.1%
NH 17 14 -3 -15.1%
NJ 148 117 -31 -20.6%
NY 436 386 -50 -11.4%
PA 181 162 -18 -10.2%
RI 23 20 -3 -14.8%
VT 14 12 -2 -13.5%
ERC total -144