The estimated effects of a per capita cap depend highly on what assumptions are made about policy specifications, future growth in Medicaid spending, and states’ responses to federal cuts. This analysis is designed to illustrate the magnitude of the impact of a per capita cap on the ACA expansion population if all states responded by maintaining their ACA expansion coverage and spending and picking up the new expansion costs. However, in practice, states may respond to the policy change differently, and many may ultimately drop their Medicaid expansion coverage over time as the magnitude of the federal spending cuts grows. ARTICLE
