Economy

Medicaid expansion faces threat as new law squeezes state budgets

The One Big Beautiful Bill Act hits budgets in two ways that will make expansion more expensive and in some cases unaffordable.
North Carolina Gov. Roy Cooper (D) signs a Medicaid expansion law at the Executive Mansion on Monday, March 27, 2023, in Raleigh, N.C. (AP Photo/Hannah Schoenbaum)

The federal government has for 15 years encouraged states to enroll more low-income adults in Medicaid. Now state legislators are scrambling as the One Big Beautiful Bill Act threatens to squeeze state budgets to such a degree that some may be forced to end Medicaid expansion altogether. 

That would leave thousands, if not millions of low-income adults without health care coverage, including many people with disabilities and adults nearing retirement age.

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