It is difficult to predict the extent of any increase in federal spending and any decrease in the number of uninsured individuals that would result if a proposed expansion of Medicaid were added to the health reform legislation pending in the Senate. The current bill includes premium assistance for individuals or families with incomes from 150 percent to 400 percent of the federal poverty level (FPL). If Medicaid eligibility were extended to individuals and families with incomes up to 150 percent of FPL, the cost would vary depending on many factors, including: (1) methodology for counting income and resources; (2) whether the benefit became available only as the proposed insurance exchanges began to operate; (3) the federal government's share of the cost of new eligibles; and (4) whether states were subject to maintenance-of-effort requirements regarding their current Medicaid programs. A increase in a broad range of around $500 billion over 10 years might be expected depending on the specifics of the legislation.
CBO Letter to Senator Judd Gregg, July 7, 2009, ¶52,912.
For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
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