With the signing of the Congressional budget bill a couple weeks ago, federal Medicaid spending could be cut by $1 trillion with an estimated increase in the number of uninsured people by 11.8 million (see the OPEN MINDS Market Intelligence Report, The 2025 Federal Budget Reconciliation Bill (H.R.1 – One Big Beautiful Bill Act): Implications For The Health & Human Service Field, and Allocating CBO’s Estimates Of Federal Medicaid Spending Reductions Across The States: Enacted Reconciliation Package).

The effects of the legislation and state policy changes in response to the budget bill will vary from state to state. The Congressional Budget Office (CBO) estimates that, in aggregate, states would replace half of the reduced federal funds with their…