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Better Care Reconciliation Act (BCRA): State-by-State Estimates of Reductions in Federal Medicaid Funding

Table 1: Estimated Change in Federal Medicaid Funds under BCRA, 2020-2029 ($ in millions)
State Change Due to:  Total Change in Federal Funds
Phase Out of Enhanced Match for ACA Expansion Per Enrollee Cap on All Groups
US Total  -301,832  -217,563  -519,395
Alabama N/A -2,032 -2,032
Alaska -1,052 -776 -1,827
Arizona -5,675 -6,129 -11,804
Arkansas -3,325 -4,137 -7,463
California -88,549 -31,281 -119,830
Colorado -6,370 -2,799 -9,169
Connecticut -6,202 -2,076 -8,278
Delaware -1,616 -772 -2,389
DC -785 -1,247 -2,032
Florida N/A -7,516 -7,516
Georgia N/A -6,634 -6,634
Hawaii -2,057 -871 -2,929
Idaho N/A -930 -930
Illinois -13,720 -6,141 -19,861
Indiana -6,692 -4,352 -11,043
Iowa -2,632 -1,880 -4,512
Kansas N/A -1,136 -1,136
Kentucky -6,613 -5,010 -11,623
Louisiana -4,264 -3,500 -7,764
Maine N/A -1,201 -1,201
Maryland -7,050 -3,991 -11,042
Massachusetts -7,582 -6,235 -13,817
Michigan -9,758 -8,572 -18,330
Minnesota -8,103 -4,340 -12,443
Mississippi N/A -2,458 -2,458
Missouri N/A -4,200 -4,200
Montana -947 -656 -1,603
Nebraska N/A -636 -636
Nevada -2,705 -1,550 -4,255
New Hampshire -1,353 -663 -2,015
New Jersey -11,567 -4,689 -16,256
New Mexico -3,081 -3,229 -6,310
New York -45,130 -14,139 -59,270
North Carolina N/A -6,973 -6,973
North Dakota -675 -348 -1,023
Ohio -10,781 -9,739 -20,520
Oklahoma N/A -2,580 -2,580
Oregon -7,919 -3,340 -11,259
Pennsylvania -17,292 -7,565 -24,857
Rhode Island -1,911 -968 -2,879
South Carolina N/A -3,653 -3,653
South Dakota N/A -335 -335
Tennessee N/A -5,462 -5,462
Texas N/A -15,951 -15,951
Utah N/A -1,627 -1,627
Vermont -1,068 -737 -1,805
Virginia N/A -2,899 -2,899
Washington -13,864 -4,941 -18,805
West Virginia -1,496 -1,890 -3,386
Wisconsin N/A -2,578 -2,578
Wyoming N/A -197 -197
NOTE: N/A: State did not expand Medicaid under the ACA. SOURCE: Kaiser Family Foundation estimates, July 2017
Table 2: Estimated Change in Federal Medicaid Funds under BCRA, 2029 ($ in millions)
State Change Due to:  Total Change in Federal Funds
Phase Out of Enhanced Match for ACA Expansion Per Enrollee Cap on All Groups
US Total -49,850 -64,091 -113,941
Alabama N/A -539 -539
Alaska -176 -210 -386
Arizona -870 -1,794 -2,664
Arkansas -505 -1,172 -1,677
California -14,838 -10,232 -25,070
Colorado -1,067 -879 -1,947
Connecticut -1,039 -762 -1,801
Delaware -266 -248 -514
DC -120 -353 -474
Florida N/A -2,008 -2,008
Georgia N/A -1,511 -1,511
Hawaii -340 -281 -621
Idaho N/A -232 -232
Illinois -2,295 -1,937 -4,232
Indiana -1,058 -1,387 -2,445
Iowa -430 -568 -999
Kansas N/A -298 -298
Kentucky -1,002 -1,605 -2,608
Louisiana -681 -1,048 -1,729
Maine N/A -309 -309
Maryland -1,181 -1,183 -2,365
Massachusetts -1,270 -1,763 -3,033
Michigan -1,550 -2,467 -4,017
Minnesota -1,358 -1,303 -2,661
Mississippi N/A -634 -634
Missouri N/A -1,072 -1,072
Montana -150 -198 -348
Nebraska N/A -171 -171
Nevada -427 -504 -931
New Hampshire -227 -203 -429
New Jersey -1,938 -1,374 -3,312
New Mexico -462 -955 -1,418
New York -7,562 -5,351 -12,914
North Carolina N/A -1,689 -1,689
North Dakota -113 -109 -222
Ohio -1,730 -2,878 -4,609
Oklahoma N/A -616 -616
Oregon -1,266 -1,113 -2,379
Pennsylvania -2,885 -2,559 -5,444
Rhode Island -319 -290 -610
South Carolina N/A -861 -861
South Dakota N/A -85 -85
Tennessee N/A -1,321 -1,321
Texas N/A -3,790 -3,790
Utah N/A -371 -371
Vermont -177 -207 -385
Virginia N/A -745 -745
Washington -2,323 -1,525 -3,848
West Virginia -222 -568 -790
Wisconsin N/A -760 -760
Wyoming N/A -50 -50
NOTE: N/A: State did not expand Medicaid under the ACA. SOURCE: Kaiser Family Foundation estimates, July 2017
Table 3: Impact of Dropping ACA Medicaid Expansion under BCRA among States that Expanded Medicaid as of July 2017, 2020-2029
($ Millions)
State Loss of Federal Funds Due to Phase Out of Enhanced FMAP & Per Enrollee Cap Additional Loss of Federal Funds if Drop ACA Expansion Total Loss of Federal Funds
US Total -519,395 -684,712 -1,204,107
Alaska -1,827 -1,967 -3,795
Arizona -11,804 -23,972 -35,775
Arkansas -7,463 -14,778 -22,240
California -119,830 -165,638 -285,468
Colorado -9,169 -11,915 -21,084
Connecticut -8,278 -11,601 -19,879
Delaware -2,389 -3,814 -6,203
DC -2,032 -3,336 -5,368
Hawaii -2,929 -4,566 -7,494
Illinois -19,861 -26,336 -46,197
Indiana -11,043 -23,004 -34,047
Iowa -4,512 -6,721 -11,233
Kentucky -11,623 -29,858 -41,481
Louisiana -7,764 -13,477 -21,241
Maryland -11,042 -13,188 -24,230
Massachusetts -13,817 -14,183 -28,000
Michigan -18,330 -32,351 -50,682
Minnesota -12,443 -15,157 -27,599
Montana -1,603 -3,224 -4,827
Nevada -4,255 -9,368 -13,623
New Hampshire -2,015 -2,530 -4,545
New Jersey -16,256 -21,637 -37,892
New Mexico -6,310 -14,675 -20,985
New York -59,270 -84,420 -143,689
North Dakota -1,023 -1,262 -2,285
Ohio -20,520 -32,774 -53,294
Oregon -11,259 -24,956 -36,215
Pennsylvania -24,857 -34,480 -59,337
Rhode Island -2,879 -3,762 -6,641
Vermont -1,805 -2,259 -4,064
Washington -18,805 -25,934 -44,739
West Virginia -3,386 -7,571 -10,956
NOTE: US Total includes spending in non-expansion states. Figures may not sum due to rounding.
SOURCE: Kaiser Family Foundation estimates, July 2017.
Table 4: Impact of Dropping ACA Medicaid Expansion under BCRA among States that Expanded Medicaid as of July 2017, 2029
  Loss of Federal Funds Due to Phase Out of Enhanced FMAP & Per Enrollee Cap
($ Millions)
Additional Loss of Federal Funds if Drop ACA Expansion
($ Millions)
Total Loss of Federal Funds
($ Millions)
Change in Medicaid Enrollment Due to Dropping Expansion % Change in Total Enrollment
US Total -113,941 -79,724 -193,665 -18,679,000 -19%
Alaska -386 -220 -607 -41,000 -19%
Arizona -2,664 -3,024 -5,688 -526,000 -21%
Arkansas -1,677 -1,872 -3,549 -382,000 -19%
California -25,070 -18,547 -43,618 -4,448,000 -29%
Colorado -1,947 -1,334 -3,281 -534,000 -30%
Connecticut -1,801 -1,299 -3,100 -261,000 -24%
Delaware -514 -447 -961 -85,000 -31%
DC -474 -421 -895 -79,000 -23%
Hawaii -621 -529 -1,151 -138,000 -31%
Illinois -4,232 -2,966 -7,198 -855,000 -21%
Indiana -2,445 -2,842 -5,287 -479,000 -31%
Iowa -999 -798 -1,797 -188,000 -23%
Kentucky -2,608 -3,788 -6,395 -557,000 -33%
Louisiana -1,729 -1,649 -3,378 -510,000 -25%
Maryland -2,365 -1,477 -3,841 -312,000 -21%
Massachusetts -3,033 -1,588 -4,621 -500,000 -19%
Michigan -4,017 -3,981 -7,997 -800,000 -25%
Minnesota -2,661 -1,697 -4,358 -280,000 -19%
Montana -348 -398 -746 -79,000 -31%
Nevada -931 -1,158 -2,089 -256,000 -35%
New Hampshire -429 -283 -713 -66,000 -26%
New Jersey -3,312 -2,423 -5,735 -694,000 -33%
New Mexico -1,418 -1,870 -3,287 -305,000 -28%
New York -12,914 -9,453 -22,367 -2,714,000 -31%
North Dakota -222 -141 -363 -27,000 -22%
Ohio -4,609 -3,990 -8,599 -858,000 -21%
Oregon -2,379 -3,052 -5,431 -692,000 -48%
Pennsylvania -5,444 -3,915 -9,359 -883,000 -25%
Rhode Island -610 -426 -1,036 -76,000 -21%
Vermont -385 -260 -644 -79,000 -33%
Washington -3,848 -2,904 -6,752 -747,000 -31%
West Virginia -790 -969 -1,759 -227,000 -30%
NOTE: US Total includes spending in non-expansion states. Figures may not sum due to rounding.
SOURCE: Kaiser Family Foundation estimates, July 2017.
Methodology

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