Pennsylvania must brace itself for a substantial decrease in federal Medicaid payments that would devastate our state budget and cause massive losses in Medicaid coverage as the Senate moves to pass a version of the House’s American Health Care Act. Under the leadership of Pennsylvania’s own junior senator, Pat Toomey, that version of the bill has significantly deeper cuts to Medicaid than the House bill. This report lays out how Senator Toomey’s new proposals would hurt the most vulnerable Pennsylvanians.