Under Trump, Medicaid faces uncertain future

President-elect Donald Trump’s vow to repeal the Affordable Care Act could gut the law’s Medicaid expansion efforts, leaving millions who have gained insurance since 2010 without coverage.

Exactly what will happen to the longstanding program that insures low-income Americans is unclear. During his presidential campaign, Trump vowed to repeal the ACA and Medicaid expansion and convert the program to block grants, which could drastically cut Medicaid funding and coverage.

However, as STAT points out, Trump also said on “The Dr. Oz Show” that under his plan, those who couldn’t afford private insurance would be eligible for Medicaid. Benjamin Sommers, a health policy expert at the Harvard T.H. Chan School of Public Health, told the news outlet that taking away coverage from millions of Americans would be fraught with political challenges.

Under a block grant program, states would receive a certain amount of funding to provide health insurance to low-income residents, an approach that proponents say would give states more leeway to control costs. Although a block grant program has received Republican support in the past, Kaiser Health News reports that it could still face resistance from legislators.

“Medicaid block grants face a very uncertain future,” Joel Cantor, director of the Center for State Health Policy at Rutgers University, told KHN.

Studies show that under the ACA, Medicaid expansion has cut uncompensated care by as much as $7.4 billion, and reduced the financial burden for hospitals, particularly those in rural areas of the country. Meanwhile, researchers have said a Medicaid block grant program would have an adverse impact on poor communities and raise new administrative complexities.