Bad news for those who use Medicaid: These states are considering cuts or restrictions
Medicaid is in the crosshairs for proposed budget cuts by Republicans in Washington but their colleagues at the state are already mulling their own.
Republican lawmakers have long opposed the expansion of Medicaid, the public health insurance program for low-income Americans. Over 21 million people, roughly a quarter of those enrolled in the program nationwide, were enrolled through Medicaid expansion as of March 2024 according to KFF.
Now in full control of the federal government they are considering cuts to Medicaid spending at the federal level, but their colleagues in a handful of states are already on the move to end or reduce their expanded Medicaid programs.
States considering Medicaid cuts or restrictions
The Affordable Care Act, aka Obamacare, signed into law in 2010 expanded Medicaid coverage beyond mainly children and their caregivers as well as those with disabilities and pregnant women to include adults earning up to 138% of the federal poverty level. The expansion has now been implemented in all but 10 states which get reimbursed for 90% of the costs of those enrollees now eligible through the expansion.
The argument from those looking to scale back or eliminate Medicaid expansion is the growing financial burden for states and the siphoning off of resources away from the traditional groups that could access health insurance from the program prior to the changes. Here’s a look at the proposals to repeal or let the program expire that have been presented in a handful of states so far:
- Arkansas: Gov. Sarah Huckabee Sanders has said she would ask to institute work requirements for adult Medicaid enrollees to qualify for coverage.
- Idaho: A bill has been introduced to repeal Medicaid expansion approved by voters. Lawmakers opposed to a full repeal have proposed work requirements.
- Montana: Competing bills are under consideration, one of which would phase out the program stopping new enrollment and removing those who become unqualified. Another would implement a strict work requirement.
- South Dakota: A proposal asks voters to allow an end to Medicaid expansion eligibility if the share of federal funding drops below 90%.
Like the proposal in South Dakota, nine states already have similar trigger laws in place. These include Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah and Virginia.
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