Senate Republicans' bill to repeal and replace Obamacare would reduce federal Medicaid outlays by 35% by 2036, according to an updated Congressional Budget office analysis released on Thursday.
Medicaid spending under the Better Care Reconciliation Act would be 26% lower in 2026 than it would be under current law, and that gap would widen to 35% by 2026, per the CBO's calculations. The drop-off would be the result of the GOP's proposed stricter limits to control Medicaid spending growth as of 2025.
The CBO on Monday estimated the bill would increase the number of people without health coverage by 22 million and cut the federal deficit by $321 billion through 2026. It also forecast it would reduce federal Medicaid spending by $772 billion within the same timeframe and cut billions of dollars in taxes for the rich. Analysts indicated a steeper Medicaid drop-off could happen after 2026, prompting some Senate Democrats asking for an estimate of exactly how much.
The CBO and Joint Committee on Taxation have not been able to quantify insurance coverage beyond the 2026 baseline and therefore can't forecast the legislation's effect on insurance coverage past the next 10 years.
"[A]fter 2026, enrollment in Medicaid would continue to fall relative to what would happen under current law," analysts wrote in Monday's CBO report.
Senate Majority Leader Mitch McConnell (R-KY) had initially planned a vote on the bill before the July 4 recess but on Tuesday announced he would put off the vote until lawmakers come back to Capitol Hill in mid-July. A number of GOP senators came out in opposition to the BCRA before the vote was postponed, including Ron Johnson (R-WI), Rand Paul (R-KY), Mike Lee (R-UT), Dean Heller (R-NV) and Susan Collins (R-ME). Even more expressed opposition when it was more politically opportune to do so, after the vote had been postponed.
"We're going to continue the discussions within our conference on the differences we have," McConnell said in a press conference after the vote was delayed.
President Trump hosted all 52 GOP Senators at the White House on Tuesday afternoon and acknowledged that while he wants to tackle healthcare, it might not happen. "It will be great if we get it done," he said. "And if we don't get it done, it's just going to be something that we're not going to like. And that's okay, and I understand that very well."