Think Progress

By: Amanda Michelle Gomez

Monday’s announcement that the 2020 census will include a question about citizenship was quickly met with uproar. Census data is in a very big way the bedrock of our democracy, as it’s used to decide congressional seats and electors in each state and how voting districts are drawn. But it’s also incredibly important for how federal funds are divvied out to state and localities. And that includes health care.

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“It’s very difficult to know how adding a citizenship question will affect states’ FMAPs,” said Karina Wagnerman, with Georgetown University’s Center for Children and Families. “However, if a state’s population decreases and a state’s income stays the same, the per capita income will increase.” And the higher the per capita income, the lower the FMAP. In other words, if the federal government thinks a state is wealthier (due to inaccurate population data), then it won’t reimburse the state as much as it should for programs like Medicaid. And when a state doesn’t get enough federal help for its health care programs, state officials will be tempted to tax citizens even more, provide a less generous insurance program, or take money from other federal assistance programs.

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