Medicaid and ACA Repeal: What Will Happen to the Safety Net?

George Washington University’s Sara Rosenbaum, one of the nation’s foremost Medicaid experts, explores how repeal of the Affordable Care Act would affect Medicaid in a new brief. In addition to eliminating the ACA’s expanded eligibility for Medicaid for both adults and children, repeal could also mean a rollback of other reforms, such as a simplified enrollment process and improvements in services and supports for people with disabilities, say Rosenbaum and her coauthors. The new administration could also expand its authority to introduce deeper structural changes, including eligibility restrictions tied to work, required premium contributions, and coverage limits and exclusions.