Congressional Republicans have floated the changes as part of a plan to slash hundreds of billions, if not trillions, of dollars from the federal budget.
The report, provided first to The Hill, outlines the consequences of policies like eliminating ObamaCare’s Medicaid expansion, lowering the federal matching rate, capping the amount of federal spending per Medicaid enrollee and block grants.
House Republicans are debating how deep they need to cut to pay for an extension of Trump’s 2017 tax cuts and his border enforcement funding. They are also eyeing hundreds of billions of dollars in savings from Medicaid changes.
The Senate Budget Committee on Friday released a blueprint that calls for the Senate Finance Committee and House Energy and Commerce Committee, which have jurisdiction over Medicaid, to find at least $1 trillion in savings.
Medicaid covers about 72 million low-income Americans, and the report notes many would be at risk of losing health insurance under the GOP's plan.
Republicans see Medicaid as a program rife with fraud and abuse, and have long sought to rein in its spending. Work requirements, one proposal most often floated, would save about $100 billion over a decade.
The most controversial changes, like lowering the federal match for the Medicaid expansion population and instituting a per capita cap, would save $561 billion and up to $900 billion over a decade respectively, according to House GOP estimates.
But the report noted that ending the enhanced expansion match rate, which is currently at 90 percent, would lead to 12 states ending their Medicaid expansion completely because of “trigger” laws tied to federal funding levels.
That means 4 million people will lose their health care, according to the report, and states could end up spending more money. GOP governors could object to the plan as a result.
