- Caitlin Owens
- Sep 18
Who wins and who loses under the latest GOP health care bill
The latest Affordable Care Act repeal and replacement bill, sponsored by Sens. Bill Cassidy, Lindsey Graham, Dean Heller and Ron Johnson, would both reduce and redistribute federal health care funding to the states. And that would create clear winners and losers among states. The left-leaning Center on Budget and Policy Priorities ran the numbers to figure out how each state would fare.
Our thought bubble: This is the biggest reason we think the Graham-Cassidy bill is unlikely to go anywhere. To pass it, GOP senators from states like Arizona and Florida would have to vote to give up federal dollars to, effectively, subsidize states like Texas and Alabama.
Data: Center on Budget and Policy Priorities analysis; Cartogram: Andrew Witherspoon / Axios
What the bill would do:
- Converts funding for the ACA's premium subsidies and Medicaid expansion into a block grant, which would result in states getting less money. This funding would stop after 2026.
- Changes the current open-ended federal match for Medicaid spending into a per-person funding cap, which also would result in less federal funding for states over time.
- Allows states to waive many of the ACA's consumer protections, like its essential health benefits and the requirement that insurers charge sick and healthy people the same premium.