Proposed Medicide Federal Federation Penalty Penalty: Estimated by State

Note: This The work reflects the recent revision of the reconciliation bill on May 21, 2025, reflecting the recent amendment to the adjustment bill to expand the FMAP penalty for the state that took the federal options to expand the scope of insurance coverage to the legal and/or pregnant women who lived in Medicaid and/or chips.

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The House of Representatives will substantially reduce the federal Medicide spending and coverage and increase the number of insurance. calculation In Congress Budget Office (CBO). that bill As a fine for guaranteeing their main funds to immigrant immigrants, there are provisions to reduce federal Medicide funds. The recent revision of this bill has expanded the scope of insurance applications for children and pregnant women who are legally residing to expand the fine for the states that have taken the federal options available in Medicaid and Children’s Health Insurance Program (Chip). Specifically, this bill is a state that lowers the federal matching rate of ACA (AFODABLE CARE Act) from 90%to 80%, providing health insurance or financial support. Qualified alien. ” Immigrants with a “qualified status” are sub -sets of immigrants in the United States.

A total of 33 states and DCs may be affected by this penalty under the latest version of the bill. According to KFF data, 14 states and DCs are for children, regardless of immigration. In the Utah and Illinois, this provision can cause federal funds and guarantees for the entire ACA Medicide expansion population because there is a “trigger” law that requires the expansion when the federal funds decrease. In addition, 19 states have occupied the federal options to expand the scope of insurance coverage to children and/or pregnant women who are legally resident of Medicaid and/or chips and adopted ACA Medicaid expansion, which can be affected by penalty. There are laws to terminate or change Medicade expansion if federal funding decreases in seven of these 19 states (Arkansas, Iowa, Montana, New Hampshire, New Mexico, North Carolina and Virginia).

This analysis investigates the potential impact of this policy change on the state Medicide expenditure, including estimates by state by state for the potential loss of federal finance when the state is maintaining the program. In addition, it is estimated that if you remove these programs based on the KFF analysis of the state registration data, budget documents, and media reports that are openly available by the government by providing registration data for 14 states dealing with some immigrants and programs supported by the state government of DC, regardless of immigration status, it is estimated. Revisions to expand the fine for the states that have expanded the federal options to expand the scope of insurance coverage to legitimate children and/or pregnant women in Medicaid and/or Chip further increase the number of people at risk of coverage. However, separate registration data cannot be used for this group.

If the state has maintained a guarantee program, it is necessary to find a way to offset the loss of federal funds. This can include reduced spending on non -medical cade services such as increased tax revenues, education, or reduced other Medicaid. When the state eliminates the program, the interest rate and barriers without care for the immigrant family will increase and the role of immigrants will have a negative impact on the US economy and manpower.

Potential impact on state spending when the state maintains guarantee and is subject to FMAP penalty

This analysis assumes that from the 2027 fiscal year, spending on those who are qualified for ACA Medicaid expansion will provide people with an application range regardless of 80% and immigrant status instead of 90% of 14 states. In addition, 19 additional states with federal options to expand the scope of insurance coverage to children and/or pregnant women in the Medicaid and/or chips estimate the effect. This analysis shows the potential impact on the main Medicide expenditure by maintaining the existing range program in response to this policy change without assuming a certain main behavior. CBO Project In violation of 14 states and DCs that provide the scope of state funding to unplicitized immigrants, $ 11 billion will be lost and 1.4 million people will be lost between 2025 and 2034. This estimates explain the assumptions of national behavioral reactions and other auxiliary effects. The CBO did not estimate the effects of a wide range of fines, including a state that expanded the scope of insurance coverage to children and/or pregnant women who legally resident of Medicaid and/or chips.

Regardless of the immigration status, according to the first fine of 14 states and DCs supported by the state, the federal government can switch $ 9.2 billion mainly for the next 10 years if the state has maintained the program.. The state Medicaid spending ranges from $ 30 billion in California to $ 300 million in Vermont, 8%in Oregon and Washington, and 3%to $ 30 million to 300 million to 300 million to 300 million to 300 million to 300 million to $ 300 million to $ 30 million to $ 30 million to $ 30 million to 300 million to $ 30 million to 300 million to $ 30 million in Massachusetts, Vermont, New York, and Minnesota in Oregon and Washington.

Depending on the latest version of the penalty, including the states that expanded the federal options to expand the federal options to expand the scope of insurance coverage to children and/or pregnant women who are legally resident of Medicaid and/or chips, the reduction of the expansion match rate can be moved from the federal government to 33 influenced states and DCs over the next 10 years. there is.. The state Medicide spending ranges from $ 30 billion in California to $ 300 million in Vermont and 14%in Louisiana, 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million to 300 million in Louisiana.

In addition, in the state, large medicaid expenditures and registration may be reduced. “Trigger” law If the federal funds are reduced, the ACA expansion range must be removed or changed.. Overall, nine out of 33 states, which are affected by the latest version of penalties, can automatically terminate or change the federal economic rates, which can lead to money and guarantee losses for the entire ACA Medicaid expansion population in this state. This week includes Arkansas, Iowa, Illinoi, Montana, New Hampshire, New Mexico, North Carolina, Utah and Virginia. According to the previous KFF analysis, if the state completely reduces the ACA Medicaid expansion range, the range of losses due to the 2034 fiscal year range from 61,000 in New Hampshire to 840,000 of Illinois and 19%of all Medicade registrants in North Carolina to 45%of Virginia (Table 1). Federal Medicide expenditures have been reduced from $ 4 billion to $ 96 billion in Illinois for 10 years in New Hampshire. The previous analysis assumed a year ago (2026 fiscal year instead of fiscal year 2027), which affects the 10 -year expenditure estimates, but does not affect the registration estimates. Perhaps it is possible many Among these expansion registrants, the health results related to financial security, treatment and medical expansion will be reversed.

If the state maintains the current guarantee, it is necessary to find a way to offset the loss of federal funds.. This can include a decrease in spending on non -Medicade services such as increasing main tax revenue, education, or reducing other medicaid cuts from the main fund or other medicaid. Considering the scale of reducing the federal Medicide funds in the reconciliation bill, the state will face significant difficulties in replacing the loss of the federal fund and the significant pressure to withdraw the current insurance application program.

If the state removes the application range to avoid FMAP penalty, the potential impact on the application range

Regardless of the immigrant status, if the state eliminates the state’s insurance benefits for immigrants, if the state removes the expansion of these groups, more than 1.9 million people can lose their health insurance benefits if the legally resident children and pregnant women can lose their guarantee.. About 1.9 million people provide insurance applications for six of children and DCs, and about 1.9 million people are applied to immigrants and seven states, and at least some adults are applied based on registered data (Table 2). This includes about 1.6 million adults and about 300,000 children, but in six states that cover children (Illinois, Maine, Massachusetts, New York, Road Island and Washington), Minnesota does not report separate data for adults and children. Thus, these data are at risk of the number of people registered in these programs and the loss of guarantee loss. In addition, the date of the registration data is different for each state. As mentioned, CBO calculation Due to the original version of the state that deals with unplanted immigrants, 1.4 million people will not be insured by 2034 by 2034. This estimation shows a different period from these registered data and assumes the status behavior as a response to the regulations. If the FMAP penalty is expanded, including the states that have acquired the federal options to expand the scope of insurance coverage to children and/or pregnant women who are legally resident, this option can lead to greater insurance benefits if the 19 -stock price coverage is removed. However, separate registration data cannot be used for this group.

The state can avoid the FMAP penalty by removing the program, but there may be a failure of insurance for insurance between immigration families.. Most immigrants are working, but they are often employed in a job that does not provide health insurance applications sponsored by employers, and immigrants who are not documented are not registered in the federal funding range options. Therefore, without such a program, most of the inexpensive coverage options cannot be accessed and insured. People who do not have insurance often can delay or go without receiving the necessary treatment, which can be worsened and expensive. Since immigrants play a big role in many jobs, including health care, construction and agriculture, the scope of insurance coverage and treatment access can have a negative impact on the US economy and manpower due to productivity loss.