NPR, March 14, 2017
Brian Naylor


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[...] Under the Affordable Care Act, 31 states and the District of Columbia chose to accept expanded coverage, which allowed people earning up to 138 percent of the poverty level to enroll in the program. Some 11 million people did. Under the GOP replacement, that expansion would be phased out, although those now in the program would not lose their coverage.

But the changes are more widespread than that. Currently, Medicaid payments to states are based on a matching formula, with the federal government paying states a share of their costs. The GOP proposes capping payments to states, with different amounts going to different categories of recipients — children, the elderly and people with disabilities.

The Congressional Budget Office, in its analysis of the GOP program, said those changes would reduce federal spending on Medicaid by $880 billion over the next 10 years, a 17.6 percent cut. And it says the changes would mean Medicaid beneficiaries would be reduced by some 14 million people — about half of the additional uninsured under the GOP bill — by 2026.

House Speaker Paul Ryan says the changes "modernize Medicaid." [...]

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