Where Medicaid Budget Cuts Would Hit Hardest

States like New York and California, but also Louisiana, Kentucky, West Virginia and New Mexico would be hit hardest by potential Medicaid cuts included in Republican budget proposals due to their higher shares of recipients of the service. This is according to an analysis by the Center for American Progress and Census data. Congressional districts in New York City, Detroit and California’s Central Valley would lose funding to the tune of $4 billion to $5 billion each over a nine-year period, the report found.

While most of the districts that top the list are represented by Democrats at the moment, CA-22 (-$5.0 billion), KY-05 (-3.6 billion), CA-23 (-3.4 billion) and LA-04 (-3.3 billion), for example, are Republican-led. The calculations include recipients of CHIP, which covers pregnant women and children.

The Republican-controlled House of Representatives passed a budget resolution on Feb. 25, which included $1.5-$2 trillion in spending cuts until 2034. These would come from Medicaid ($880 billion), SNAP and similar benefits ($230 billion) as well as student loan interest, fees and related programs ($330 billion). While a first version of the Senate budget blueprint passed by Republicans on Feb. 21 did not include such deep cuts, both versions now have to be reconciled. For the time being, a stopgap bill is expected to be passed with the support of Democrats in the Senate today, which would fund the government through Sept. 30 as the House has already signed off on it.

On the other side of the long-term House resolution stands the extension of the Tax Cuts and Jobs Act of 2017, which would otherwise be expiring. The provisions would cost $3.6 trillion through 2034, including $1.8 trillion for individual income and estate tax cuts for those earning more than $400,000 annually and $900 billion in new tax cuts that are expected to go to corporations. The Center on Budget and Policy Priorities comments that the proposal constitutes tax cuts for the wealthy that are paid for by taking away essentials like health care and food from people in need.

Largest Cuts In History

Medicaid cuts of this volume would constitute the largest in American history, said House Minority Leader Hakeem Jeffries, himself representing one of the top 10 most affected districts should the plan come to fruition, NY-08. Most of the United States’ Northeastern states would be among the more afflicted, as would be the Great Lakes region.

In Michigan and Ohio, as well as in North Carolina, a relatively large number of constituents would lose coverage under the proposal. This is due to the fact that these states chose to expand Medicaid and CHIP enrollment, while other populous ones like Texas, Florida and Georgia did not. Medicaid expansion, a provision of the Affordable Care Act, means that states can opt to determine Medicaid enrollment on income alone, instead of having income be one of several factors that decides eligibility.

Fewer people in relation to population were dependent on Medicaid and CHIP in the Dakotas, Utah, Kansas, Wyoming and New Hampshire. Yet, even the least affected districts stand to lose upwards of $700 million in funding over nine years, not a small sum either.

Charted by Statista