This new fact sheet examines key questions around the potential changes President-elect Donald Trump and the next Congress may seek to make in Medicaid, a program that covers 73 million people nationally.

Depending on how it is structured, a repeal of the Affordable Care Act could reverse the expansion of Medicaid coverage that helped bring the nation’s uninsured rate to a historic low. The brief also examines the prospect of capping and reducing federal financing for Medicaid through a block grant or a per capita cap. These approaches are typically designed to save the federal government money and provide states with additional flexibility but, depending on how they are structured, could put populations and providers who disproportionately rely on Medicaid funding — including the elderly and people with disabilities, nursing homes and safety net hospitals – at risk.

The fact sheet also discusses how executive powers can be used to make changes to Medicaid without congressional action, including new regulations and Medicaid waivers.