Spotlight on the Impact of the Senate Better Care Reconciliation Act on Total Medicaid Spending

These new fact sheets show the depth of Medicaid cuts proposed by the BCRA in Alaska, Colorado, Nevada, North Dakota, Ohio and West Virginia.

For more than 50 years, the Medicaid program has served as a critical safety net for millions of people who deplete their life savings and turn to Medicaid for assistance as their ability to care for themselves declines. The Better Care Reconciliation Act (BCRA) threatens the Medicaid program by limiting future federal funding that states can receive to provide needed health care and long-term services and supports (LTSS). Specifically, the bill repeals the Medicaid expansion and implements a capped financing model for states.

New fact sheets from the AARP Public Policy Institute illustrates the depth of the cuts in select states and shows the implications of the BCRA for Medicaid funding and enrollment.


These states stand to lose more than $79 billion in total Medicaid funding through fiscal year (FY 2026).


Total Cut to Medicaid (Federal and State), FY2020-2026


$3 billion


$17.2 billion


$10.7 billion

North Dakota

$1.7 billion


$37.4 billion

West Virginia

$1.9 billion



Total Cut to these Six States

$79.1 billion


By FY 2026, more than 1.4 million people in these states could lose their Medicaid coverage under the bill.


Total Loss of Medicaid Coverage, FY2026







North Dakota




West Virginia






Total Coverage Loss in these Six States



The fact sheets include three new data points illustrating the extent of BCRA’s Medicaid financing cuts:

  • The annual cut to total (federal and state) Medicaid funding through fiscal year (FY) 2026,
  • The cumulative cut to total (federal and state) Medicaid funding from FY 2020-FY 2026,
  • The number of beneficiaries who would have to lose coverage by FY2026 in order for those remaining to maintain their current level of service.

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