State Medicaid budgets to weather $664B reduction through 2034 due to OBBBA: RAND

Fierce Healthcare – Monday, March 2, 2026
By Dave Muoio

A collective $664 billion is set to disappear from states’ Medicaid budgets through 2034 as a result of policy changes included in last summer’s One Big Beautiful Bill Act, according to new state-by-state projections from RAND.

The nonprofit think tank’s analysis also outlines an $87 billion decline across the states’ general funds due to the landmark legislation. The shift is expected to generate federal savings of $714 billion under RAND’s measure, which is roughly in line with that of the Congressional Budget Office.

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