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An released Feb. 13 by KFF found that a proposal to cut the Affordable Care Act's Medicaid expansion match rate could reduce total Medicaid spending by up to $1.9 trillion over a 10-year period, causing potentially 20 million people to lose Medicaid coverage. The analysis contains state-by-state estimates for two scenarios if Congress reduces the federal match from 90% to either 70% or 50% for the costs of covering individuals under Medicaid expansion. 
 
The first scenario assumes that all states would maintain their Medicaid expansion by replacing lost federal funding with increased state funding, and no enrollees would lose coverage. This would result in a decrease in federal Medicaid spending of 10%, or $626 billion, across all states during a 10-year period, and a corresponding increase in collective state Medicaid spending of 17% (also $626 billion) during the same period, KFF said. 
 
The second scenario assumes states would not recoup the funding shortfall from federal cuts and drop Medicaid expansion, resulting in a $1.7 trillion decrease in federal Medicaid spending and a $186 billion decrease in state Medicaid spending across all states over a 10-year period. This example would result in a $1.9 trillion decline in total Medicaid spending.