(1) Medicaid is now jointly financed as an open-ended shared responsibility between the federal government and state governments; the AHCA proposes a major change in financing with a per capita cap. (2) The shift to per capita caps would limit federal Medicaid contributions--a change that is likely to have fiscal implications for states and enrollees, including 11 million people with both Medicare and Medicaid. (3) The impact on any given state will depend on a number of factors, including the growth in the share of its 85+ (highest cost) population. (4) States with costs that exceed the cap for their senior or disabled enrollees would need to find other revenues to maintain coverage, or reduce costs.
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