A new law signed by President Donald Trump that would give states the option of expanding Medicaid has been slammed by experts who say it is a poor investment in the future of the American health care system.
The bill, which will become law on Friday, is the largest expansion of Medicaid in the nation’s history.
The proposal would allow states to pick from three pools of people eligible for Medicaid and would require states to use a formula to determine how much money they receive from the federal government.
The Congressional Budget Office estimates that it would save states nearly $2 billion over 10 years, but that could be offset by rising costs for the federal program.
The CBO estimates that the expansion would cost states $1.8 billion in 2018 and $3.4 billion in 2026, and would result in a shortfall of $831 billion over the next decade, according to a report by the Congressional Budget Service released Thursday.
In addition, it estimates that states would spend $1 billion on a new program for people who get their health insurance through a work program, such as a cafeteria, nursing home or home health agency.
The nonpartisan Congressional Budget and Policy Center estimated that the federal expansion would increase federal spending by $826 billion over 20 years.
“This is an incredibly risky program, especially in the context of the fact that states have already been struggling to make ends meet and have seen their finances spiral out of control,” said John J. Miller, director of the Center for American Progress, a left-leaning think tank in Washington.
“And in order to do that, we need to be smart about the investments we make in health care and in public education.
This is a massive step backwards for Americans, not to mention the fact it’s just a bad deal for Americans.”
The legislation, which is called the Health Care Freedom Act, is part of a broader strategy to overhaul the federal health care structure.
It would give Congress and the president the authority to negotiate and pass new health care legislation, with the goal of repealing the Affordable Care Act and replacing it with a national health care program that would be more generous and affordable for the nation.
“The American people deserve better than this bill,” said Sen. Bernie Sanders, I-Vt., who is the ranking member of the Senate Budget Committee.
“It is an attack on the most vulnerable Americans and an attack against the middle class.
This bill is a political and economic disaster for the American people.”
The CBO estimated that Medicaid expansion would raise federal spending $2.2 trillion over 10 to 20 years, a number that could rise because states would be required to spend the additional money on additional programs.
States would also be required, in some cases, to cover additional costs for new insurance plans or increase the number of people covered by Medicaid.
For instance, a state that expanded Medicaid would have to pay an additional $7 billion to cover people who have not been covered for six months and pay an extra $1,000 for every extra person covered.
“States will need to ensure that the Medicaid expansion continues to help address the cost of Medicaid coverage, including the cost associated with expanding Medicaid coverage to people with preexisting conditions,” the CBO estimated.
A Medicaid expansion also would lead to a significant increase in the number and number of uninsured people.
The law’s impact on the federal budget would be hard to gauge because it would take years to figure out exactly how the federal money would be spent.
Some estimates have shown that states could spend a significant amount of the money.
“I do not think that the CBO can say what would happen to the federal deficit over the 10-year period of this plan,” said Michael Tanner, a senior fellow at the Urban Institute.
“But I think there are significant uncertainties about how it would impact the economy and what that would mean for the growth in the unemployment rate.”
Critics argue that the bill would harm states and the federal economy.
“Medicaid expansion would create a massive financial and administrative burden on the states and a significant financial burden on our country,” said Rep. Sean Patrick Maloney, D-N.Y., a member of House Democratic leadership.
“By putting billions of dollars into this expansion, we would be subsidizing states that are already struggling to maintain Medicaid coverage.”
The White House has said that the administration has no plans to change Medicaid and that the states have the ability to choose whether to expand.
In a statement to NBC News, the administration said it supports states having the flexibility to decide whether to continue expanding Medicaid, but added that it does not support plans that limit Medicaid coverage or impose higher costs on low-income Americans.
The expansion would expand coverage to millions of people who are currently covered by private health insurance plans.
The White Center on Budget and Economic Policy estimates that expansion would result from expanding the number who are eligible to receive health coverage through Medicaid.
The policy analysts estimate that the number would increase from 6.2 million today