The Impact of the Senate Health Care Bill on Veterans: State-by-State Breakdown

Dr. Adam Mileski talks with Army veteran Rory Killilea on June 24, 2017, in Spokane Valley, Washington.

A new analysis by the Center for American Progress finds that 459,500 veterans would lose Medicaid coverage by 2026 under the U.S. Senate Republicans’ plan to repeal and replace the Affordable Care Act (ACA). This is an even larger number than the 441,300 veterans who would lose Medicaid coverage under the House Republicans’ plan.

The Impact of the AHCA on Veterans: State-by-State Breakdown

AP/Randall Hill
President Trump and congressional Republicans’ health care plan would take Medicaid away from more than 400,000 veterans.

Written behind closed doors, the Senate bill—like the House bill—breaks President Donald Trump’s promises to protect Medicaid and support veterans. The House and Senate proposals also both betray veterans by permitting states to make changes to essential health benefits. These changes would reduce current protections for veterans with pre-existing conditions—including service-connected disabilities such as spinal cord injuries, amputations, and post-traumatic stress disorder—and result in large increases in medical costs for some veterans and their families.

America’s 20 million veterans, the majority of whom do not get their health care insurance from the U.S. Department of Veterans Affairs—including 1.8 million who are covered by Medicaid—deserve better.

The table below shows state-by-state breakdowns of the estimated number of veterans who would lose Medicaid coverage by 2026 under the cuts proposed in Senate Republicans’ Better Care Reconciliation Act (BCRA). (see Methodology)

Methodology

The authors’ calculations of state-level estimates of Medicaid coverage loss among veterans are based on estimates from a June 2017 CAP column by Emily Gee regarding overall state-level health insurance losses under the BCRA. The authors used state-level data on veterans’ Medicaid enrollment in 2015 from the American Community Survey (ACS) 2015 1-year estimates, accessed through the Integrated Public Use Microdata Series, and projected what veterans’ Medicaid enrollment would be in 2026 under the ACA by assuming that the number of veterans enrolled in Medicaid would change at the same rate as the Department of Veterans Affairs forecast of the total number of veterans in each state. The authors then assumed that the share of veterans losing Medicaid coverage under the BCRA by 2026 would be the same as the share of all adults—which, for the purposes of Medicaid, includes individuals ages 19 and older—losing coverage by 2026. To compute the reduction in Medicaid coverage among adults in 2026, the authors first scaled up states’ 2015 adult Medicaid enrollment from ACS 2015 1-year estimates according to total projected Medicaid enrollment among adults in 2026 given in the nonpartisan Congressional Budget Office’s (CBO’s) March 2016 budget projections, which the CBO used in its score of the BCRA. The authors used estimated state-level coverage losses among all adults ages 19 and older from the Gee column to compute the percentage by which Medicaid coverage would decline by 2026. Finally, the authors applied these percentage coverage losses to their state-level projection of 2026 Medicaid enrollment among veterans.

Note that this analysis assumes that the share of veterans enrolled in Medicaid in each state remains constant over time, which produces a conservative estimate for two reasons: First, rates of disability for veterans have increased since 2001, and second, the CBO projects that if the ACA is not repealed, additional states will expand Medicaid, extending Medicaid coverage to an additional 5 million people, some of whom would likely be veterans.

Katherine Gallagher Robbins is the director of family policy for the Poverty to Prosperity Program at the Center for American Progress. Rachel West is an associate director for the Poverty to Prosperity Program at the Center. Rejane Frederick is an associate director for the Poverty to Prosperity Program at the Center.