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Medicaid Cuts and the States: Tracking State-Specific Estimates of the Impacts of Proposed Changes [1]

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Date: 2025-05

Medicaid Cuts and the States: Tracking State-Specific Estimates of the Impacts of Proposed Changes

Elizabeth Lukanen and Emily Zylla, SHADAC

Congress is considering a variety of federal policy changes that will have significant impacts on the Medicaid program, including reduced enrollment and decreased federal Medicaid funding to states. While none of these cuts to Medicaid have been codified into law, federal and state agencies, advocates, and research organizations have all sought to estimate the potential impacts on Medicaid enrollment and spending. A growing number of national analyses, some focusing on individual states, and others providing parallel analyses across all 50 states, offer valuable insights into the implications of these proposals. These estimates can be helpful tools for state staff as they consider how federal policy changes might impact their unique Medicaid programs.

Individual state agencies continue to publicly release their own estimates seeking to quantify the impacts of federal policy changes on their respective state Medicaid programs (see below). The majority of these provide information on cost impacts as well as enrollment. However, they vary significantly in terms of the timeframes examined (for example, New Mexico provides both annual and five-year estimates of impacts), the amount of detail provided about assumptions used to generate estimates, and the documentation of data sources used. Some states, like Kentucky, are also publishing estimates with enhanced details such as projections of impacts by county, congressional districts, and individual hospitals. In addition to its quantitative estimates of financial and enrollment impacts, Wisconsin includes qualitative reflections on the potential impacts of proposed cuts. Other states, such as New Mexico, detail separate state funding impacts from federal funding impacts.

In this rapidly evolving policy environment, it is crucial to continue to monitor potential impacts of proposed changes and cuts to Medicaid. Many states have indicated that they plan to update their analyses as specific bill language and/or more policy details become available. SHADAC will continue to regularly monitor published estimates from states, updating this page as a resource. If your state has produced estimates that should be included in this expert perspective, please contact us here.

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[1] Url: https://www.shvs.org/medicaid-cuts-and-the-states-tracking-state-specific-estimates-of-the-impacts-of-proposed-changes/

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