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Republican proposals to convert Medicaid into a block grant program would cut government payments to nursing homes by $220.2 billion between 2013 and 2022, a new analysis finds.

Turning Medicaid into a block grant program — which would provide states with a fixed sum to spend on Medicaid — would save the federal government $1.7 trillion between 2013 to 2022, according to an analysis released Tuesday by the Urban Institute for the Kaiser Family Foundation. But, it would also mean that between 31 million and 38 million fewer low-income people would be covered by Medicaid, according to the report.

“Under the reductions from the block grant, payments to hospitals could fall by $363.8 billion and payments to nursing homes by $220.2 billion over the 2013 to 2022 period, a 22% reduction, assuming that states made cuts across the  board,” the Kaiser report said.

The U.S. House passed federal budgets in 2011 and 2012 that would have repealed the Affordable Care Act and its massive expansion of Medicaid. Rep. Paul Ryan (R-WI), Mitt Romney’s running mate, authored and championed those budget proposals. Both Ryan and Romney support the use of block grants for Medicaid, which they say give states more flexibility in running the program. Medicaid pays for the vast majority of nursing home care in the United States.

Click here to read the full report.