I wonder how states are going to respond to the Medicaid cuts.
Many purple (and blue) states might start increasing state-funding or maybe introduce buy-in programs is my guess. Purple states tend to be the most competitive when it comes to economic policies (highest unemployment insurances, highest per capita funding for medicaid and energy assistance programs, etc.)
For example, here in Pennsylvania there is a bipartisan bill (including many Republicans as sponsors) to create a paid family leave program of 20 weeks.
https://www.billtrack50.com/billdetail/1900578
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This bill establishes the Pennsylvania Family and Medical Leave Program, creating a state-run paid leave system that allows employees to take up to 20 weeks of paid leave in a year for various reasons, including caring for a new child, caring for a family member with a serious health condition, addressing personal health issues, supporting a family member who is a victim of violence, or addressing military deployment-related needs. The program will be funded through a payroll contribution of up to 1% from employees, with benefits calculated based on a sliding scale that replaces a higher percentage of wages for lower-income workers. Employees must work at least 18 weeks and earn at least $2,718 in the previous year to be eligible. The bill provides job protection for employees taking leave, requires employers to maintain health benefits during leave, and prohibits retaliation against employees who use the program. Self-employed individuals can also opt into the program. The Department of Labor and Industry will administer the program, establish an advisory board, conduct public outreach, and submit annual reports on the program's performance. Employees who are denied benefits or believe their rights have been violated can file complaints and potentially pursue civil action. The program is set to become effective 180 days after the bill's passage.
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A Medicaid buy-in with income-based premiums would go a long way to balancing out the losses of federal funding, in my opinion and could expand health-care to those who are between the lowest earners and the median earners who are often the most vulnerable when it comes to health-insurance. I might send a letter to my state reps to see if they'd consider it.
Also with the tax cuts at the federal level, states might be able to increase their taxes a bit. As a person in the top 5% I am probably going to get a 2-3% income boost from this, and wouldn't might paying that towards higher state taxes (Pennsylvania has a flat 3.07% income tax.)
