What will it mean if the proposed House budget cuts are allowed to happen
If the senate passes the approved $880 billion budget cut from the house, we could very well see a rollback of all of the progress the expansion has set in place
A couple weeks ago the house passed an $880 billion budget cut to the Energy and Commerce committee which is primarily responsible for Medicaid funding.
The Republican House Budget Resolution’s Potential $880 Billion in Medicaid Cuts by Congressional District
The Republican House budget resolution would cost congressional districts an average of $2 billion each and could eliminate coverage for 15.9 million people.
Sarah Nadeau Associate Director, Media Relations
In 2014, the Medicaid Expansion plan took effect which increased the ability for more individuals to obtain Medicaid coverage, this included individuals up to 138% of the poverty level. This meant individuals making $20,780 annually or a family making $35,630 annually could apply for coverage from Medicaid, a state run medical assistance program (Medicaid Expansion: FAQ).
There are many misunderstandings when it comes to the Medicaid program and the individuals who are able to obtain coverage under the current rules and guidelines. Only 40 of the 50 states in the US have adopted the expansion and there have been more positive effects of expansion seen in the states who did expand over the states that chose not to expand.
- How it affected hospitals:
- Between 2013 and 2015, in the expansion states there was a decrease in uncompensated costs by almost $6.2 billion across 31 states and DC.
- Expansion is even more important to rural areas due to the increased need of Medicaid services. Since 2010, 82 rural hospitals have had to close and mostly those can be found in the non-expanded states.
- Employment:
- In 2022, approximately 91% of non-elderly medicaid adults worked full-time, part-time, acted as a caregiver, attended school or had an illness.
- 61% of disabled people where it affects their ability to work were still employed.
- Closing coverage gaps:
- Between 2013-2022, coverage gaps between white and Black people shrank by 67% in those states that participated in expansion where in those states that did not participate, the gap only closed by 47%.
- In the same amount of time, coverage gaps between white and Latinx people shrank by 48% in states where they participated in expansion as opposed to only 30% decrease in states that did not participate in expansion.
- Decreasing maternal & infant deaths:
- Infant mortality decreased by 50% in expansion states while 200 maternal deaths were prevented in 2017.
- Premature deaths:
- In adults ages 55 to 64, 19,200 lives were saved through Medicaid expansion (2014 & 2017).
- In the same group of individuals in non-expansion states, 15,600 died prematurely.
The Center for American Progress has estimated how much money each district stands to lose if this budget cut proposal is allowed to be signed into law. Then based on if the state expanded or not, has estimated how many enrollments this will cause the state to cancel to recoup any money lost from the decreased federal dollars. To get a clear picture, I have combined more information to show the impact this will have on each state. Using data from 2023 for consistency, I have included the following additional information: Total Medicaid spending, % Federal vs. % State Medicaid spending, Total population by state (estimate), % Medicaid coverage for children (0-18), % population by state for children (0-18). Lastly, I show where the states electoral votes went in the 2024 election simply to show how they line up with this potential budget cut proposal.
- Alabama: 9 electoral votes to Trump/Vance
- Population on Medicaid: 1,036,743 (20%)
- Medicaid Spending 2023: $7.88 billion
- Federal (77.6%): $6.11 billion
- State (22.4%): $1.77 billion
- Alabama did not participate in expansion
- Estimated loss of federal funds over 9 years: $1.44 billion/year ($12.98 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (59.3%): $4.67 billion
- State (40.7%): $3.21 billion
- Population ages 0-18: 1,200,490 (23.5% of total population)
- Children (ages 0-18) on Medicaid: 545,022 (45.5% of children)
- Alaska: 3 electoral votes to Trump/Vance
- Population on Medicaid: 164,703 (22 %)
- Medicaid Spending 2023: $2.5 billion
- Federal (78%): $2 billion
- State (22%): $56 million
- Estimated loss of enrollment (expansion state): Approximately 41,000 lost enrollments decreasing to only 123,703 getting Medicaid services (17% of state population)
- Estimated loss of federal funds over 9 years: $22.9 million/year ($2.06 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (77.3%): $1.98 billion
- State (22.7%): $78.9 million
- Population ages 0-18: 189,952 (25.9% of total population)
- Children (ages 0-18) on Medicaid: 68,573 (36.1% of children)
- Arizona: 11 electoral votes to Trump/Vance
- Population on Medicaid: 1,500,913 (20.2%)
- Medicaid Spending 2023: $22.19 billion
- Federal (80.7%): $17.9 billion
- State (19.3%): $4.3 billion
- Estimated loss of enrollment (expansion state): Approximately 528,000 lost enrollments decreasing to only 972,913 getting Medicaid services (13.1% of state population)
- Estimated loss of federal funds over 9 years: $2.09 billion/year ($18.78 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (71.2%): $15.8 billion
- State (28.8%): $6.38 billion
- Population ages 0-18: 695,694 (22.7% of total population)
- Children (ages 0-18) on Medicaid: 250,450 (36% of children)
- Arkansas: 6 electoral votes to Trump/Vance
- Population on Medicaid: 768,675 (25.1%)
- Medicaid Spending 2023: $8.64 billion
- Federal (80.8%): $6.98 billion
- State (19.2 %): $1.7 billion
- Estimated loss of enrollment (expansion state): Approximately 275,000 lost enrollments decreasing to only 493,675 getting Medicaid services (16% of state population)
- Estimated loss of federal funds over 9 years: $1.07 billion/year ($9.63 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (68.4%): $5.91 billion
- State (31.6%): $2.73 billion
- Population ages 0-18: 744,730 (24.3% of total population)
- Children (ages 0-18) on Medicaid: 35,077 (47.1% of children)
- California: 54 electoral votes to Harris/Walz
- Population on Medicaid: 10,474,055 (27%)
- Medicaid Spending 2023: $124.06 billion
- Federal (65.6%): $81.4 billion
- State (34.4%): $42.7 billion
- Estimated loss of enrollment (expansion state): Approximately 3,159,000 lost enrollments decreasing to only 7,315,055 getting Medicaid services (18.8% of state population)
- Estimated loss of federal funds over 9 years: $14.6 billion/year ($131.03 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (53.8%): $66.8 billion
- State (46.2%): $57.26 billion
- Population ages 0-18: 8,961,994 (23% of total population)
- Children (ages 0-18) on Medicaid: 3,862,620 (43.1% of children)
- Colorado: 10 electoral votes to Harris/Walz
- Population on Medicaid: 1,082,782 (18.4%)
- Medicaid Spending 2023: $12.96 billion
- Federal (63.3%): $8.2 billion
- State (36.4%): $4.7 billion
- Estimated loss of enrollment (expansion state): Approximately 387,000 lost enrollments decreasing to only 695,782 getting Medicaid services (12% of state population)
- Estimated loss of federal funds over 9 years: $1.5 billion/year ($13.56 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (51.7%): $6.7 billion
- State (48.3%): $6.26 billion
- Population ages 0-18: 1,287,197 (21.9% of total population)
- Children (ages 0-18) on Medicaid: 442,796 (34.4% of children)
- Connecticut: 7 electoral votes to Harris/Walz
- Population on Medicaid: 803,845 (22%)
- Medicaid Spending 2023: $10.43 billion
- Federal (63.4%): $6.6 billion
- State (36.6%): $3.8 billion
- Estimated loss of enrollment (expansion state): Approximately 205,000 lost enrollments decreasing to only 598,845 getting Medicaid services (17% of state population)
- Estimated loss of federal funds over 9 years: $1.1 billion/year ($10.04 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (52.7%): $5.5 billion
- State (47.3%): $4.93 billion
- Population ages 0-18: 774,076 (21.4% of total population)
- Children (ages 0-18) on Medicaid: 291,827 (37.7% of children)
- Delaware: 3 electoral votes to Harris/Walz
- Population on Medicaid: 218,119 (21%)
- Medicaid Spending 2023: $3.3 billion
- Federal (72%): $2.38 billion
- State (28%): $924 million
- Estimated loss of enrollment (expansion state): Approximately 56,000 lost enrollments decreasing to only 162,119 getting Medicaid services (16% of state population)
- Estimated loss of federal funds over 9 years: $303 million/year ($2.73 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (62.9%): $2.077 billion
- State (37.1%): $1.223 billion
- Population ages 0-18: 225,984 (21.9% of total population)
- Children (ages 0-18) on Medicaid: 88,812 (39.3% of children)
- Florida: 30 electoral votes to Trump/Vance
- Population on Medicaid: 3,839,118 (17%)
- Medicaid Spending 2023: $34.6 billion
- Federal (65.2%): $22.6 billion
- State (34.8%): $12 billion
- Florida did not participate in expansion
- Estimated loss of federal funds over 9 years: $5.5 billion/year ($49.49 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (49.4%): $17.1 billion
- State (50.1%): $17.5 billion
- Population ages 0-18: 4,635,094 (20.5% of total population)
- Children (ages 0-18) on Medicaid: 1,826,227 (39.4% of children)
- Georgia: 16 electoral votes to Trump/Vance
- Population on Medicaid: 2,035,910 (18%)
- Medicaid Spending 2023: $16.01 billion
- Federal (71.3%): $11.4 billion
- State (28.7%): $4.6 billion
- Georgia did not participate in expansion
- Estimated loss of federal funds over 9 years: $2.83 billion/year ($2546 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (53.5%): $8.57 billion
- State (46.4%): $7.43 billion
- Population ages 0-18: 2,713,190 (24.6% of total population)
- Children (ages 0-18) on Medicaid: 1,131,400 (41.7% of children)
- Hawaii: 4 electoral votes to Harris/Walz
- Population on Medicaid: 281,178 (19.6%)
- Medicaid Spending 2023: $3.04 billion
- Federal (73%): $2.22 billion
- State (27%): $821 million
- Estimated loss of enrollment (expansion state): Approximately 75,000 lost enrollments decreasing to only 206,178 getting Medicaid services (14.4% of state population)
- Estimated loss of federal funds over 9 years: $391 million/year ($3.52 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (60.2%): $1.829 billion
- State (39.9%): $1.212 billion
- Population ages 0-18: 317,165 (22.1% of total population)
- Children (ages 0-18) on Medicaid: 112,594 (35.5% of children)
- Idaho: 4 electoral votes to Trump/Vance
- Population on Medicaid: 358,454 (18.2%)
- Medicaid Spending 2023: $3.58 billion
- Federal (79.9%): $2.86 billion
- State (20.1%): $720 million
- Estimated loss of enrollment (expansion state): Approximately 103,000 lost enrollments decreasing to only 255,454 getting Medicaid services (13% of state population)
- Estimated loss of federal funds over 9 years: $500 million/year ($4.49 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (65.9%): $2.36 billion
- State (34.1%): $1.22 billion
- Population ages 0-18: 497,076 (25.3% of total population)
- Children (ages 0-18) on Medicaid: 166,520 (33.5% of children)
- Illinois: 19 electoral votes to Harris/Walz
- Population on Medicaid: 2,460,518 (19.6%)
- Medicaid Spending 2023: $32.2 billion
- Federal (65.2%): $21.05 billion
- State (34.8%): $11.23 billion
- Estimated loss of enrollment (expansion state): Approximately 539,000 lost enrollments decreasing to only 1,921,518 getting Medicaid services (15.3% of state population)
- Estimated loss of federal funds over 9 years: $3.42 billion/year ($30.81 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (54.6%): $17.63 billion
- State (45.4%): $14.65 billion
- Population ages 0-18: 2,873,879 (22.9% of population)
- Children (ages 0-18) on Medicaid: 1,017,353 (35.4% of children)
- Indiana: 11 electoral votes to Trump/Vance
- Population on Medicaid: 1,430,126 (20.8%)
- Medicaid Spending 2023: $17.35 billion
- Federal (75.4%): $13.1 billion
- State (24.6%): $4.27 billion
- Estimated loss of enrollment (expansion state): Approximately 484,000 lost enrollments decreasing to only 946,126 getting Medicaid services (13.8% of state population)
- Estimated loss of federal funds over 9 years: $1.99 billion/year ($17.89 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (64%): $11.11 billion
- State (36%): $6.26 billion
- Population ages 0-18: 1,674,377 (24.4% of population)
- Children (ages 0-18) on Medicaid: 614,496 (36.7% of children)
- Iowa: 6 electoral votes to Trump/Vance
- Population on Medicaid: 650,265 (20.3%)
- Medicaid Spending 2023: $6.92 billion
- Federal (72.6%): $5 billion
- State (27.4%): $1.9 billion
- Estimated loss of enrollment (expansion state): Approximately 173,000 lost enrollments decreasing to only 477,265 getting Medicaid services (14.9% of state population)
- Estimated loss of federal funds over 9 years: $904 million/year ($8.14 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (59.2%): $4.096 billion
- State (40.8%): $2.824 billion
- Population ages 0-18: 769,681 (24% of total population)
- Children (ages 0-18) on Medicaid: 294,788 (38.3% of children)
- Kansas: 6 electoral votes to Trump/Vance
- Population on Medicaid: 421,444 (14.3%)
- Medicaid Spending 2023: $5.22 billion
- Federal (64.9%): $3.39 billion
- State (35.1%): $1.83 billion
- Kansas did not participate in expansion
- Estimated loss of federal funds over 9 years: $587 million/year ($5.28 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (53.4%): $2.8 billion
- State (46.4%): $2.42 billion
- Population ages 0-18: 735,137 (25% of total population)
- Children (ages 0-18) on Medicaid: 224,217 (30.5% of children)
- Kentucky: 8 electoral votes to Trump
- Population on Medicaid: 1,244,013 (27.5%)
- Medicaid Spending 2023: $16.32 billion
- Federal (81.7%): $13.3 billion
- State (18.3%): $2.99 billion
- Estimated loss of enrollment (expansion state): Approximately 475,000 lost enrollments decreasing to only 769,013 getting Medicaid services (17% of state population)
- Estimated loss of federal funds over 9 years: $1.73 billion/year ($15.57 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (70.9%): $11.57 billion
- State (29.1%): $4.75 billion
- Population ages 0-18: 1,068,172 (23.6% of total population)
- Children (ages 0-18) on Medicaid: 494,564 (46.3% of children)
- Louisiana: 8 electoral votes to Trump/Vance
- Population on Medicaid: 1,448,513 (32%)
- Medicaid Spending 2023: $16.39 billion
- Federal (79.4%): $13 billion
- State (20.6%): $3.38 billion
- Estimated loss of enrollment (expansion state): Approximately 497,000 lost enrollments decreasing to only 951,513 getting Medicaid services (20.8% of state population)
- Estimated loss of federal funds over 9 years: $2.01 billion/year ($18.12 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (67.1%): $10.99 billion
- State (32.9%): $5.4 billion
- Population ages 0-18: 1,138,864 (24.9% of total population)
- Children (ages 0-18) on Medicaid: 613,847 (53.9% of children)
- Maine: 3 electoral votes to Harris/Walz & 1 electoral vote to Trump/Vance
- Population on Medicaid: 293,402 (21%)
- Medicaid Spending 2023: $4.18 billion
- Federal (72.2%): $3.02 billion
- State (27.8%): $1.16 billion
- Estimated loss of enrollment (expansion state): Approximately 44,000 lost enrollments decreasing to only 294,402 getting Medicaid services (17.9% of state population)
- Estimated loss of federal funds over 9 years: $409 million/year ($3.68 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (62.5%): $2.611 billion
- State (37.5%): $1.569 billion
- Population ages 0-18: 256,813 (18.4% of total population)
- Children (ages 0-18) on Medicaid: 90,912 (35.4% of children)
- Maryland: 10 electoral votes to Harris/Walz
- Population on Medicaid: 1,161,681 (18.8%)
- Medicaid Spending 2023: $16.99 billion
- Federal (63.5%): $10.8 billion
- State (36.5%): $6.2 billion
- Estimated loss of enrollment (expansion state): Approximately 300,000 lost enrollments decreasing to only 861,681 getting Medicaid services (13.9% of state population)
- Estimated loss of federal funds over 9 years: $1.6 billion/year ($14.53 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (54.1%): $9.2 billion
- State (45.9%): $7.79 billion
- Population ages 0-18: 1,439,999 (23.3% of total population)
- Children (ages 0-18) on Medicaid: 468,000 (32.5% of children)
- Massachusetts: 11 electoral votes to Harris/Walz
- Population on Medicaid: 1,622,862 (23.3%)
- Medicaid Spending 2023: $23.41 billion
- Federal (60.8%): $14.23 billion
- State (39.2%): $9.18 billion
- Estimated loss of enrollment (expansion state): Approximately 230,000 lost enrollments decreasing to only 1,392,862 getting Medicaid services (19.9% of state population)
- Estimated loss of federal funds over 9 years: $2.26 billion/year ($20.3 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (51.1%): $11.97 billion
- State (48.9%): $11.44 billion
- Population ages 0-18: 1,435,287 (20.5% of total population)
- Children (ages 0-18) on Medicaid: 499,480 (34.8% of children)
- Michigan: 15 electoral votes to Trump/Vance
- Population on Medicaid: 2,369,407 (24%)
- Medicaid Spending 2023: $23.36 billion
- Federal (76.1%): $17.8 billion
- State (23.9%): $5.58 billion
- Estimated loss of enrollment (expansion state): Approximately 648,000 lost enrollments decreasing to only 1,721,407 getting Medicaid services (17.2% of state population)
- Estimated loss of federal funds over 9 years: $3.3 billion/year ($29.66 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (62.1%): $14.5 billion
- State (37.9%): $8.86 billion
- Population ages 0-18: 2,228,272 (22.2% of total population)
- Children (ages 0-18) on Medicaid: 866,798 (38.9% of children)
- Minnesota: 10 electoral votes to Harris/Walz
- Population on Medicaid: 1,046,885 (18.2%)
- Medicaid Spending 2023: $18.51 billion
- Federal (63.6%): $11.77 billion
- State (36.4%): $6.74 billion
- Estimated loss of enrollment (expansion state): Approximately 197,000 lost enrollments decreasing to only 849,885 getting Medicaid services (14.8% of state population)
- Estimated loss of federal funds over 9 years: $1.46 billion/year ($13.11 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (55.7%): $10.31 billion
- State (44.3%): $8.2 billion
- Population ages 0-18: 1,359,886 (23.7% of total population)
- Children (ages 0-18) on Medicaid: 429,724 (31.6% of children)
- Mississippi: 6 electoral votes to Trump/Vance
- Population on Medicaid: 675,762 (23%)
- Medicaid Spending 2023: $6.35 billion
- Federal (82.5%): $5.24 billion
- State (17.5%): $1.1 billion
- Mississippi did not participate in expansion
- Estimated loss of federal funds over 9 years: $939 million/year ($8.45 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (67.7%): $4.301 billion
- State (32.3%): $2.049 billion
- Population ages 0-18: 726,103 (24.7% of population)
- Children (ages 0-18) on Medicaid: 352,160 (48.5% of children)
- Missouri: 10 electoral votes to Trump/Vance
- Population on Medicaid: 1,031,587 (16.6%)
- Medicaid Spending 2023: $15.94 billion
- Federal (78.5%): $12.5 billion
- State (21.5%): $3.4 billion
- Estimated loss of enrollment (expansion state): Approximately 277,000 lost enrollments decreasing to only 754,587 getting Medicaid services (12.2% of state population)
- Estimated loss of federal funds over 9 years: $1.5 billion/year ($13.48 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (69%): $11 billion
- State (31%): $4.94 billion
- Population ages 0-18: 1,443,704 (23.3% of total population)
- Children (ages 0-18) on Medicaid: 522,621 (36.2% of children)
- Montana: 4 electoral votes to Trump/Vance
- Population on Medicaid: 234,687 (20.7%)
- Medicaid Spending 2023: $2.63 billion
- Federal (79.9%): $2.1 billion
- State (20.1%): $529 million
- Estimated loss of enrollment (expansion state): Approximately 91,000 lost enrollments decreasing to only 143,687 getting Medicaid services (12.7% of state population)
- Estimated loss of federal funds over 9 years: $326 million/year ($2.93 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (67.5%): $1.774 billion
- State (32.5%): $855 million
- Population ages 0-18: 248,086 (21.9% of total population)
- Children (ages 0-18) on Medicaid: 99,979 (40.3% of children)
- Nebraska: 1 electoral vote to Harris/Walz & 4 electoral votes to Trump/Vance
- Population on Medicaid: 321,048 (16.2%)
- Medicaid Spending 2023: $3.77 billion
- Federal (69.6%): $2.62 billion
- State (30.4%): $1.15 billion
- Estimated loss of enrollment (expansion state): Approximately 77,000 lost enrollments decreasing to only 244,048 getting Medicaid services (12.3% of state population)
- Estimated loss of federal funds over 9 years: $447 million/year ($4.02 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (57.6%): $2.173 billion
- State (42.4%): $1.597 billion
- Population ages 0-18: 508,443 (25.7% of total population)
- Children (ages 0-18) on Medicaid: 164,227 (32.3% of children)
- Nevada: 6 electoral votes to Trump/Vance
- Population on Medicaid: 654,676 (20.5%)
- Medicaid Spending 2023: $5.61 billion
- Federal (77.1%): $4.33 billion
- State (22.9%): $1.28 billion
- Estimated loss of enrollment (expansion state): Approximately 245,000 lost enrollments decreasing to only 409,676 getting Medicaid services (12.8% of state population)
- Estimated loss of federal funds over 9 years: $911 million/year ($8.2 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (60.9%): $3.419 billion
- State (39.1%): $2.191 billion
- Population ages 0-18: 721,884 (22.6% of the total population)
- Children (ages 0-18) on Medicaid: 278,647 (38.6% of children)
- New Hampshire: 4 electoral votes to Harris/Walz
- Population on Medicaid: 183,488 (13.1%)
- Medicaid Spending 2023: $2.46 billion
- Federal (61.3%): $1.51 billion
- State (38.7%): $952 million
- Estimated loss of enrollment (expansion state): Approximately 63,000 lost enrollments decreasing to only 120,488 getting Medicaid services (8.6% of state population)
- Estimated loss of federal funds over 9 years: $256 million/year ($2.3 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (51%): $1.254 billion
- State (49%): $1.208 billion
- Population ages 0-18: 267,792 (19.1% of total population)
- Children (ages 0-18) on Medicaid: 80,605 (30.1% of children)
- New Jersey: 14 electoral votes to Harris/Walz
- Population on Medicaid: 1,734,230 (18.7%)
- Medicaid Spending 2023: $22.66 billion
- Federal (64.1%): $14.5 billion
- State (35.9%): $8.13 billion
- Estimated loss of enrollment (expansion state): Approximately 479,000 lost enrollments decreasing to only 1,255,230 getting Medicaid services (13.5% of state population)
- Estimated loss of federal funds over 9 years: $2.41 billion/year ($21.69 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (53.4%): $12.09 billion
- State (46.6%): $10.54 billion
- Population ages 0-18: 2,127,603 (22.9% of total population)
- Children (ages 0-18) on Medicaid: 710,619 (33.4% of children)
- New Mexico: 5 electoral votes to Harris/Walz
- Population on Medicaid: 709,684 (33.6%)
- Medicaid Spending 2023: $8.12 billion
- Federal (82.9%): $6.73 billion
- State (17.1%): $1.39 billion
- Estimated loss of enrollment (expansion state): Approximately 280,000 lost enrollments decreasing to only 429,684 getting Medicaid services (20.3% of state population)
- Estimated loss of federal funds over 9 years: $987 million/year ($8.88 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (70.7%): $5.743 billion
- State (29.3%): $2.377 billion
- Population ages 0-18: 482,077 (22.8% of total population)
- Children (ages 0-18) on Medicaid: 292,138 (60.6% of children)
- New York: 28 electoral votes to Harris/Walz
- Population on Medicaid: 5,573,815 (28.5%)
- Medicaid Spending 2023: $97.86 billion
- Federal (63.8%): $62.4 billion
- State (36.2%): $35.4 billion
- Estimated loss of enrollment (expansion state): Approximately 1,843,000 lost enrollments decreasing to only 3,730,815 getting Medicaid services (19.1% of state population)
- Estimated loss of federal funds over 9 years: $7.75 billion/year ($69.73 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (55.8%): $54.65 billion
- State (44.2%): $43.15 billion
- Population ages 0-18: 4,149,098 (21.2% of total population)
- Children (ages 0-18) on Medicaid: 1,825,603 (44% of children)
- North Carolina: 16 electoral votes to Trump/Vance
- Population on Medicaid: 2,186,393 (20.2%)
- Medicaid Spending 2023: $19.44 billion
- Federal (72.9%): $14.17 billion
- State (27.1%): $5.27 billion
- Estimated loss of enrollment (expansion state): Approximately 766,000 lost enrollments decreasing to only 1,420,393 getting Medicaid services (13.1% of state population)
- Estimated loss of federal funds over 9 years: $2.83 billion/year ($25.43 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (58.3%): $11.34 billion
- State (41.7%): $8.1 billion
- Population ages 0-18: 2,481,327 (22.9% of total population)
- Children (ages 0-18) on Medicaid: 1,024,289 (41.5% of children)
- North Dakota: 3 electoral votes to Trump/Vance
- Population on Medicaid: 974,426 (12.4%)
- Medicaid Spending 2023: $1.52 billion
- Federal (66%): $1 billion
- State (34%): $517 million
- Estimated loss of enrollment (expansion state): Approximately 28,000 lost enrollments decreasing to only 69,426 getting Medicaid services (9% of state population)
- Estimated loss of federal funds over 9 years: $136 million/year ($1.22 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (57%): $864 million
- State (43%): $653 million
- Population ages 0-18: 192,062 (24.5% of population)
- Children (ages 0-18) on Medicaid: 44,174 (23% of children)
- Ohio: 17 electoral votes to Trump/Vance
- Population on Medicaid: 2,508,2000 (21.3%)
- Medicaid Spending 2023: $31.85 billion
- Federal (74%): $23.57 billion
- State (26%): $8.28 billion
- Estimated loss of enrollment (expansion state): Approximately 643,000 lost enrollments decreasing to only 1,865,200 getting Medicaid services (15.8% of state population)
- Estimated loss of federal funds over 9 years: $3.49 billion/year ($31.37 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (62.8%): $20.01 billion
- State (37.2%): $11.77 billion
- Population ages 0-18: 2,722,551 (23.1% of total population)
- Children (ages 0-18) on Medicaid: 1,020,957 (37.5% of children)
- Oklahoma: 7 electoral votes to Trump/Vance
- Population on Medicaid: 914,812 (22.6%)
- Medicaid Spending 2023: $9.57 billion
- Federal (81.8%): $7.83 billion
- State (18.2%): $1.74 billion
- Estimated loss of enrollment (expansion state): Approximately 226,000 lost enrollments decreasing to only 688,812 getting Medicaid services (17% of state population)
- Estimated loss of federal funds over 9 years: $1.27 billion/year ($11.45 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (68.5%): $6.56 billion
- State (31.5%): $3.01 billion
- Population ages 0-18: 1,037,779 (25.6% of total population)
- Children (ages 0-18) on Medicaid: 483,605 (46.6% of children)
- Oregon: 8 electoral votes to Harris/Walz
- Population on Medicaid: 1,000,428 (23.6%)
- Medicaid Spending 2023: $14.8 billion
- Federal (75.5%): $11.2 billion
- State (24.5%): $3.6 billion
- Estimated loss of enrollment (expansion state): Approximately 317,000 lost enrollments decreasing to only 683,428 getting Medicaid services (16.1% of state population)
- Estimated loss of federal funds over 9 years: $1.39 billion/year ($12.51 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (66.3%): $9.81 billion
- State (33.7%): $4.99 billion
- Population ages 0-18: 872,072 (20.6% of total population)
- Children (ages 0-18) on Medicaid: 348,829 (40% of children)
- Pennsylvania: 19 electoral votes to Trump/Vance
- Population on Medicaid: 2,746,560 (21.2%)
- Medicaid Spending 2023: $44 billion
- Federal (63.5%): $27.9 billion
- State (36.5%): $16.1 billion
- Estimated loss of enrollment (expansion state): Approximately 799,000 lost enrollments decreasing to only 1,947,560 getting Medicaid services (15% of state population)
- Estimated loss of federal funds over 9 years: $3.82 billion/year ($34.36 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (54.7%): $24.08 billion
- State (45.3%): $19.92 billion
- Population ages 0-18: 2,799,724 (21.6% of total population)
- Children (ages 0-18) on Medicaid: 1,091,892 (39% of children)
- Rhode Island: 4 electoral votes to Harris/Walz
- Population on Medicaid: 241,397 (22%)
- Medicaid Spending 2023: $3.47 billion
- Federal (66.2%): $2.3 billion
- State (33.8%): $1.17 billion
- Estimated loss of enrollment (expansion state): Approximately 72,000 lost enrollments decreasing to only 169,397 getting Medicaid services (15.5% of state population)
- Estimated loss of federal funds over 9 years: $336 million/year (3.02 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (56.6%): $1.964 billion
- State (43.4%): $1.506 billion
- Population ages 0-18: 219,192 (20% of total population)
- Children (ages 0-18) on Medicaid: 80,882 (36.9% of children)
- South Carolina: 9 electoral votes to Trump/Vance
- Population on Medicaid: 1,056,361 (19.7%)
- Medicaid Spending 2023: $8.91 billion
- Federal (75.4%): $6.72 billion
- State (24.6%): $2.19 billion
- South Carolina did not participate in expansion
- Estimated loss of federal funds over 9 years: $1.47 billion/year ($13.23 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (58.9%): $5.25 billion
- State (41.1%): $3.66 billion
- Population ages 0-18: 1,214,423 (22.6% of total population)
- Children (ages 0-18) on Medicaid: 527,060 (43.4% of children)
- South Dakota: 3 electoral votes to Trump/Vance
- Population on Medicaid: 131,797 (14.3%)
- Medicaid Spending 2023: $1.19 billion
- Federal (68.3%): $813 million
- State (31.7%): $377 million
- Estimated loss of enrollment (expansion state): Approximately 42,000 lost enrollments decreasing to only 89,797 getting Medicaid services (9.8% of state population)
- Estimated loss of federal funds over 9 years: $183 million/year ($1.65 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (53%): $630 million
- State (47%): $560 million
- Population ages 0-18: 235,345 (25.6% of total population)
- Children (ages 0-18) on Medicaid: 69,898 (29.7% of children)
- Tennessee: 11 electoral votes to Trump/Vance
- Population on Medicaid: 1,399,526 (19.6%)
- Medicaid Spending 2023: $12.56 billion
- Federal (70.9%): $8.9 billion
- State (29.1%): $3.65 billion
- Tennessee did not participate in expansion
- Estimated loss of federal funds over 9 years: $1.95 billion/year ($17.52 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (55.3%): $6.95 billion
- State (44.7%): $5.6 billion
- Population ages 0-18: 1,646,219 (23.1% of total population)
- Children (ages 0-18) on Medicaid: 693,058 (42.1% of children)
- Texas: 40 electoral votes to Trump/Vance
- Population on Medicaid: 4,863,844 (15.9%)
- Medicaid Spending 2023: $57.28 billion
- Federal (65.3%): $37.4 billion
- State (34.7%): $19.88 billion
- Texas did not participate in expansion
- Estimated loss of federal funds over 9 years: $6.76 billion/year ($60.88 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (53.5%): $30.64 billion
- State (46.5%): $26.64 billion
- Population ages 0-18: 8,022,368 (26.3% of total population)
- Children (ages 0-18) on Medicaid: 2,904,097 (36.2% of children)
- Utah: 6 electoral votes to Trump/Vance
- Population on Medicaid: 379,516 (10.9%)
- Medicaid Spending 2023: $4.57 billion
- Federal (75.5%): $3.45 billion
- State (24.5%): $1.12 billion
- Estimated loss of enrollment (expansion state): Approximately 113,000 lost enrollments decreasing to only 266,516 getting Medicaid services (7.7% of state population)
- Estimated loss of federal funds over 9 years: $528 million/year ($4.75 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (57.2%): $12.49 billion
- State (42.6%): $9.3 billion
- Population ages 0-18: 2,022,042 (23.2% of total population)
- Children (ages 0-18) on Medicaid: 624,811 (30.9% of children)
- Vermont: 3 electoral votes to Harris/Walz
- Population on Medicaid: 143,657 (22.2%)
- Medicaid Spending 2023: $2 billion
- Federal (65.7%): $1.3 billion
- State (34.3%): $686 million
- Estimated loss of enrollment (expansion state): Approximately 17,000 lost enrollments decreasing to only 126,657 getting Medicaid services (19.6% of state population)
- Estimated loss of federal funds over 9 years: $200 million/year ($1.8 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (55%): $1.1 billion
- State (45%): $900 million
- Population ages 0-18: 121,723 (18.8% of total population)
- Children (ages 0-18) on Medicaid: 49,541 (40.7% of children)
- Virginia: 13 electoral votes to Harris/Walz
- Population on Medicaid: 1,448,386 (16.6%)
- Medicaid Spending 2023: $21.84 billion
- Federal (66.6%): $14.5 billion
- State (33.4%): $7.29 billion
- Estimated loss of enrollment (expansion state): Approximately 418,000 lost enrollments decreasing to only 1,030,386 getting Medicaid services (11.8% of state population)
- Estimated loss of federal funds over 9 years: $2.01 billion/year ($18.13 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (57.2%): $12.49 billion
- State (42.6%): $9.3 billion
- Population ages 0-18: 2,022,042 (23.3% of total population)
- Children (ages 0-18) on Medicaid: 624,811 (30.9% of children)
- Washington: 12 electoral votes to Harris/Walz
- Population on Medicaid: 1,587,955 (20.3%)
- Medicaid Spending 2023: $29.2 billion
- Federal (69%): $20.1 billion
- State (31%): $9.05 billion
- Estimated loss of enrollment (expansion state): Approximately 471,000 lost enrollments decreasing to only 1,116,955 getting Medicaid services (14.3% of state population)
- Estimated loss of federal funds over 9 years: $2.21 billion/year ($19.88 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (61.2%): $17.89 billion
- State (38.7%): $11.26 billion
- Population ages 0-18: 1,742,272 (22.3% of total population)
- Children (ages 0-18) on Medicaid: 667,290 (38.3% of children)
- West Virginia: 4 electoral votes to Trump/Vance
- Population on Medicaid: 458,964 (26%)
- Medicaid Spending 2023: $5.47 billion
- Federal (81.8%): $4.47 billion
- State (18.2%): $996 million
- Estimated loss of enrollment (expansion state): Approximately 155,000 lost enrollments decreasing to only 303,964 getting Medicaid services (17.2% of state population)
- Estimated loss of federal funds over 9 years: $638 million/year ($5.74 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (70%): $3.832 billion
- State (30%): $1.634 billion
- Population ages 0-18: 375,255 (21.2% of total population)
- Children (ages 0-18) on Medicaid: 168,490 (44.9% of children)
- Wisconsin: 10 electoral votes to Trump/Vance
- Population on Medicaid: 1,082,464 (18.3%)
- Medicaid Spending 2023: $12.07 billion
- Federal (65.1%): $7.86 billion
- State (34.9%): $4.21 billion
- Wisconsin did not participate in expansion
- Estimated loss of federal funds over 9 years: $1.5 billion/year ($13.54 billion total)
- Projected spending on Medicaid services after cuts:
- Federal (52.7%): $6.36 billion
- State (47.3%): $5.71 billion
- Population ages 0-18: 1,312,232 (22,2% of total population)
- Children (ages 0-18) on Medicaid: 436,973 (33.3% of children)
- Wyoming: 3 electoral votes to Trump/Vance
- Population on Medicaid: 79,182 (13.6%)
- Medicaid Spending 2023: $725.67 million
- Federal (58.6%): $425 million
- State (41.4%): $300 million
- Wyoming did not participate in expansion
- Estimated loss of federal funds over 9 years: $110.1 million/year ($990.79 million total)
- Projected spending on Medicaid services after cuts:
- Federal (43.4%): $314.9 million
- State (56.5%): $410.1 million
- Population ages 0-18: 139,006 (23.8% of total population)
- Children (ages 0-18) on Medicaid: 48,791 (35.1% of children)
What does all of this mean if approved? Well, not only will it roll back all the positive progress we have seen in the expansion states but it will require every state to make up the difference. The only way to make up this difference is to cut funding to other state services or to increase taxes within the state. Either way, it will cause a strain on all citizens across the country. When putting together any type of budget which includes services to humans, especially services which are necessary and a human right, you cannot cut the budget like this proposal without causing harm. But also, medical costs have been trending upwards, especially after 2020 and the beginning of the COVID pandemic. It is fiscally irresponsible to not ensure actual costs predicted to be accrued and not leave enough money to cover those costs, not when you have data to suggest the need.
References for Data:
Total Medicaid spending - 2023
Federal and state share of Medicaid spending -2023
Population distribution by age