1. United States
2. Mont.
3. Letter

Reducing federal Medicaid expansion funding would put health coverage at immediate risk for over 3 million Americans across 9 states that have trigger laws to swiftly end their Medicaid expansions. These states are Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah, and Virginia. The Affordable Care Act allowed states to expand Medicaid to cover more low-income adults, with the federal government paying 90% of the costs for this expanded population. Cutting this funding would force state legislatures to either increase spending significantly to continue coverage or drop expansion entirely, leading to more uninsured individuals and reduced access to care. The expansion has helped drive down uninsured rates and provide vital coverage, so maintaining federal support is crucial for preserving these coverage gains across both Republican and Democratic-led states. Triggering coverage losses for millions would undermine the progress made in improving healthcare access under the ACA.