As President Donald Trump continues to push his healthcare law through Congress, he has been forced to use the Congressional Budget Office (CBO) to justify his policies.
The CBO has repeatedly warned that the law is likely to cause more than $500 billion in additional spending to the federal government over the next decade.
But that spending could easily come at the expense of the states.
According to the American Health Care Act (AHCA), states are required to expand Medicaid, which covers about 30 million people, while providing coverage to about 8 million more.
The states are also required to offer insurance to about 14 million of those people, which will be funded through the ACA’s subsidies.
But many states, including Arizona, Oklahoma, and Utah, have resisted the Medicaid expansion and opted instead to opt out of the subsidies.
The result is that the federal funds that have been spent on expanding Medicaid have not reached the states’ needy populations, according to the CBO.
As a result, the states are expected to receive $9.5 billion more in federal funding than they were supposed to receive, according a recent report from the nonpartisan Congressional Budget Center (CBI).
As a consequence, the CBO predicts that about half of the funding for Medicaid expansion will come from states, while the rest will come via the federal subsidy program.
While the CBO is projecting that states will receive $7.8 billion more per year from the ACA than they would have received had they opted out of Medicaid expansion, the state’s share of federal Medicaid funds will be far less.
According the CBO, states that opted out would have gotten $5.8 million more per person, while those that opted in would have been left with just $2.5 million.
While there are a number of ways the states could have managed to secure more money, they would be left with $5 billion less in federal dollars.
In a statement to The Hill, the American Legislative Exchange Council (ALEC) slammed the states for their decision to opt-out of the Medicaid expansions.
The statement from the state of Colorado argues that, “it’s clear that many states are going to lose money as a result of this decision.
Colorado also will be forced to take Medicaid funds from the federal program that covers nearly 60 million of its residents.”
ALEC’s statement also cites the CBO’s previous analysis that the ACA will result in spending of about $5 trillion over 10 years, but that the CBO expects that figure to decrease by about $300 billion after 2020.
The fact that the states were forced to opt in means that the Congressional budget office (CBP) will continue to provide the states with the benefits they are receiving in exchange for their support.
The decision by Colorado and Utah to opt into the Medicaid program also means that those states have no incentive to spend more than the $4.2 billion in federal funds allocated to them, which is why they opted not to expand.
As The Hill previously reported, “the states that opt-in will receive federal funding that will cover about half their Medicaid costs, and $1.5 trillion in federal money will be provided for the other half of their Medicaid cost, according the CBO.”
The states will also receive an additional $3 billion in tax relief, which could be offset by the additional federal funding they receive.
The American Legislative Council (Alec) also released a statement in response to the states decision.
The Council’s statement argues that “Colorado is not alone, and we applaud states like Colorado who have chosen to opt back into Medicaid expansion.
But it is wrong to say that states can opt out without losing federal funding.
The Congressional Budget office estimates that the average Medicaid cost would be $2,000 higher in 2020, and about $3,600 lower in 2030.
It is not surprising that many of the state legislatures and governors in these states have decided to opt away from the expansion.
It will mean the loss of billions of dollars in federal Medicaid funding for the states.”
The CBO is also expected to update its projections for Medicaid over the coming months, according To the Hill.
But even if the states continue to opt, the Congressional Congressional Budget Bureau predicts that the additional funding they will receive from the CBO will decrease by $300 million by 2020, compared to the year before.