A brief released jointly by the Robert Wood Johnson Foundation and the Urban Institute used estimates from the Congressional Budget Office (CBO) and modeling from the Urban Institute (Health Insurance Policy Simulation Model) to estimate state-level impacts of declines in future healthcare reductions in light of current policies on the horizon.

Their analysis shows the effects on healthcare spending by state if Affordable Care Act Marketplace coverage Enhanced Premium Tax Credits expire along with coverage losses attributable to H.R. 1. Enhanced Premium Tax Credits were extended through the Inflation Reduction Act increasing the amount of tax credits available to individuals making between 100% and 400% of federal poverty.

This made insurance more affordable and accessible resulting in a nearly 13 million more individuals having health insurance through the marketplace. The brief concludes that spending on healthcare over the 10-year budget cycle will decrease by more than $1 trillion. Both policies combine show staggering reductions that align more with population totals than Medicaid budgets or expenditure.

Authors Fredric Blavin and Michael Simpson demonstrate a variety of scenarios and how healthcare spending will be affected in each state.

The brief can be downloaded here.