Another study has examined the losses that will be absorbed by the American Health Care Act per capita cap as well as Speaker Ryan’s Better Way proposal. This study, The Impact of Per Capita Caps on Federal and State Medicaid Spending was conducted by the Urban Institute with the support of the Robert Wood Johnson Foundation. It actually shows lesser cuts under the American Health Care Act then the CBO score because they say it is too difficult for all or most states to increase taxes or cut benefits or reduce already low reimbursement rates to offset losses of federal funding. The study does show the Better Way proposal to result in cuts at the same level of the CBO analysis.
The analysis also states that if states where to increase their own state spending to make up for the loss in federal Medicaid funding spending would have to increase by 29 percent under the Better Way proposal and by 16 percent under the House-passed American Health Care Act. The state spending increases would be largest in states such as Kentucky, West Virginia, Montana, New Mexico and Oregon.
The report also includes a state by state calculation of losses under the two Medicaid cut proposals. Under the Better Way proposal Colorado, New Jersey and Washington state would be the biggest losers with funding declining by 27 percent while several small states would suffer the lowest losses of 12 percent. Under the House passed plan the biggest losers would be the states of Colorado and New Jersey losing 20 percent while Wyoming would lose 3.1 percent. The losses are based on a ten-year impact.