The Affordable Care Act will probably be repealed without a replacement in place, according to a new report from the Urban Institute.
The nonpartisan think tank looked at how the repeal of the law, which Republicans are seeking to do by rolling back taxes, regulations, and other spending, would affect Medicare and the Medicaid program for the poor.
The Urban Institute’s report found that, in its first two years of repeal, the Medicaid expansion would be substantially less likely to be expanded under Trump than under President Obama.
In the years after repeal, Medicare beneficiaries will be less likely than under current law to get Medicare Advantage plans.
The report found a similar effect in the years following repeal.
“This was driven in part by the ACA’s repeal of a range of state and local tax credits,” the report said.
“These changes resulted in more people being enrolled in private Medicare Advantage health plans and more people receiving care outside of traditional Medicare Advantage coverage.”
But the report also found that states that expanded Medicaid in the year after repeal would have to take on additional federal funding to keep Medicaid enrollment up.
This could be costly and time consuming.
For example, if states that extended Medicaid had to raise taxes, they could only do so if the tax credits they offered were higher than the taxes they were not able to offer.
The study found that a state would have less money to spend if it extended Medicaid than if it continued to spend tax dollars on other things, such as expanding Medicaid eligibility, paying for the expansion, and providing additional services for low-income people.
To be sure, it’s possible that states would still be able to expand Medicaid under Trump, and the authors say it’s important to know how it would work.
But if you look at the actual Medicaid expansion, it seems likely that states will continue to expand it as they’ve done under previous Republican administrations.
A recent Kaiser Family Foundation report found states that added Medicaid had increased the number of people enrolled in Medicaid over the last decade.
In a report released in April, the Urban Policy Group found that expanding Medicaid would be “one of the most cost-effective policies” in the US.
However, the report found there was also a cost.
“The cost of expanding Medicaid could be higher than expected if it’s funded by tax increases, such that states could incur more administrative costs than expected, increase their Medicaid costs by raising premiums, or increase administrative costs for Medicaid beneficiaries,” the Urban researchers wrote.
What the Urban study found is that if states continued to expand their Medicaid programs, there would be fewer people with access to healthcare, which would lead to higher rates of uninsuredness and higher costs for taxpayers.
If you would like to read more on this topic, read Vox’s explainer.
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