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The Affordable Care Act allowed states to expand their Medicaid programs, and revolutionized federal spending on Medicare and the benefits it offers. Now, eight years after the Affordable Care Act improved our health care, President Trump and his Republican allies in Congress are taking steps to turn the clock back and restrict access to Medicaid and Medicare.

Key Affordable Care Act Improvements …

  • Children’s enrollment: The Affordable Care Act raised the financial eligibility for adults on  Medicaid to 138 percent of the federal poverty line. It is estimated that because of this change, 710,000 children gained coverage when their parents signed up for Medicaid. Since the Affordable Care Act was passed, children’s uninsured rate has fallen from 8 percent to 5 percent.
  • Medicaid expansion: Thanks to the Affordable Care Act, 32 states expanded their Medicaid programs to include individuals up to 138 percent of federal poverty line. Because of this expansion, more than 12 million Americans who had not been eligible for Medicaid now have coverage.
  • Medicaid enrollment: Medicaid covers 1 in 5 Americans, approximately 76 million people.  Nearly 12 million Medicaid enrollees were newly eligible for the program because of the Affordable Care Act, and Medicaid plays a critical role for many more:
    • Medicaid is important for family health: nearly half of all births in the U.S. are covered by Medicaid.
    • Medicaid supports our elders: 62 percent of nursing home residents are covered by Medicaid.
  • Medicare: The Affordable Care Act helped lower federal spending on Medicare Advantage plans and improved Medicare benefit plans by providing free coverage for services like breast cancer, cardiovascular disease, and diabetes screening.

… and How Republicans Would Drag Us Back

  • Children’s enrollment: Republican efforts to repeal and replace the Affordable Care Act, and restructure Medicaid funding threatens to roll back Children’s coverage gains made through Medicaid expansion. It is estimated that if the ACA is repealed, 4.4 million children may lose coverage.
  • Medicaid expansion: President Trump’s budget calls on Congress to pass the Republican repeal bill, Graham-Cassidy, that would end Medicaid expansion in 2020 and leave the 12 million Americans newly enrolled in Medicaid without coverage.
  • Medicaid enrollment: The Trump Administration is encouraging states to impose requirements that people work in order to enroll in Medicaid. HHS has approved these requirements for three states, and approval is pending for even more.
    • Work requirements are fundamentally bureaucratic hurdles designed to restrict access to Medicaid. Experts predict that requiring enrollees verify their employment or work-related activities will reduce enrollment among those still eligible for Medicaid.
  • Medicare: Last December, Congressional Republicans passed a massive tax bill that slashes taxes for corporations and the the top one percent. To pay for these cuts, Republicans have proposed cutting funding to Medicare by $473 billion.