When the Affordable Care Act was adopted in 2010 it offered a powerful incentive for states to expand their Medicaid program: the federal government would pick up 90 percent of the cost of covering each state’s expansion population.
Over the years, 40 of the 50 states have taken advantage of these terms to expand their Medicaid programs, resulting in a significant increase in both Medicaid enrollment and how much the federal government spends on Medicaid.
Now, policymakers are considering ending that incentive, leaving the 40 states with a difficult choice: to pick up the additional cost themselves or reverse their eligibility expansion. An added complication is that some of the mechanisms states use to raise their share of their Medicaid costs, most notably provider taxes, are being reconsidered as well.
In the face of such policy discussions, KFF Health has taken a closer look at the implications of the end of the enhanced Medicaid expansion federal matching rate and in a new report describes the proposal and its implications for Medicaid spending and enrollment, showing the potential impact on a state-by-state basis. The report also identifies states that passed “trigger” laws that would require them to reverse their Medicaid expansion if the financial terms change or to reduce their Medicaid benefits to reflect the loss of federal resources.
Learn more from the KFF Health report “Eliminating the Medicaid Expansion Federal Match Rate: State-by-State Estimates.”