Financing
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How Would Changes to Federal Medicaid Expansion Funding Impact People in “Trigger” States and Those with Expansion Enshrined in State Constitutions?
Congress is currently considering draconian cuts to Medicaid that would mean millions of low-income Americans lose access to affordable health care. But both the type of federal cuts and how the joint state-federal Medicaid program operates in each state mean that the impact on people living in different states would vary considerably. The major difference…
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Cuts to ACA’s Medicaid Expansion Under Consideration by Congress would Lead to Large Coverage Losses Hitting some States Harder than Others
Next week, the House Energy and Commerce Committee is expected to consider fast-track budget reconciliation legislation that could cut Medicaid by as much as $880 billion over 10 years or more. This level of cuts to Medicaid is unprecedented and if enacted would mean tens of millions of children, parents, seniors, people with disabilities and…
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New State-by-State Estimates of the Federal Funding Cuts from Imposing a Per Capita Cap on the Medicaid Expansion
I previously warned about how imposing a per capita cap on the Medicaid expansion would effectively lead to a sharp cut to the current 90 percent matching rate for the 40 states and the District of Columbia that have adopted the expansion. This would shift significant costs to states, force them to drop their expansions…
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Governors and State Agencies Estimate Impact of Potential Federal Medicaid Cuts on State Budgets
With Congress returning to DC, we expect to learn more about the Medicaid cuts under serious consideration as part of the budget reconciliation process fairly soon. But, in the meantime, states are starting to crunch some numbers to gauge the impact of the potential Medicaid cuts on their state programs and state budgets. The analysts…
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Voices from Ohio: The Harm of Medicaid Work Requirements
As Congress considers imposing a mandatory work reporting requirement (WRR) on adults in Medicaid as part of their drive to impose large federal cuts to Medicaid, Ohio is the first state during the second Trump Administration to request Section 1115 demonstration authority to impose a WRR on its ACA Medicaid expansion group. Ohioans are speaking…
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Medicaid Fraud: The Improper Use of Improper Payments
Welcome to another installment on the misuse of the Medicaid “improper payments” metric. This conversation began in 2018, then continued in 2020, 2022, and this year. For those just joining, Brian Blase of the Paragon Institute and his colleague, Rachel Greszler of the Economic Policy Innovation Center, have launched yet another misguided assault on federal…
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Imposing a Per Capita Cap on the Medicaid Expansion Would Lead to an Effective Cut in the Expansion Matching Rate for States
On March 5, according to Axios, House Energy and Commerce Committee Chair Brett Guthrie (R-KY) is now considering a proposal to impose a per capita cap on the Medicaid expansion as part of budget reconciliation. Chairman Guthrie, as well as other House Republican leaders, may believe that such a cap could be viewed as more…
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Same Playbook: Major Medicaid Cuts under Consideration for Budget Reconciliation Similar to Medicaid Cuts in Failed ACA Repeal Bills from 2017
This week, the House is scheduled to vote on a budget resolution that would require the House Energy and Commerce Committee to make at least $880 billion over ten years in mandatory spending cuts as part of budget reconciliation legislation, most or all of which would come from Medicaid. The draconian Medicaid cuts under consideration…
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Webinar: The Truth about Fraud Against Medicaid
The Georgetown University Center for Children and Families invites you to a special session of our new Child Medicaid Policy Institute (CMPI) on Tuesday, January 28 at 2pm ET. This webinar is free and open to the public. CMPI seeks to educate child health advocates, providers, other stakeholders, and policymakers on the fundamentals of the…
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The Truth about Waste and Abuse in Medicaid
“States are abusing federal Medicaid policy. There is an enormous amount of waste, fraud and abuse in the program.” – Brian Blase, President, Paragon Health Institute, as reported in Stat (January 6, 2025) This falsehood is one premise for the proposals to cut federal Medicaid spending by $2.3 trillion (with a “t”) over the next…
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Cutting Federal Medicaid Payments to States: Bad News for Their Credit Ratings
Medicaid is the nation’s largest health insurer, covering over 70 million Americans. And, as a new CCF report documents, it is a particularly important source of coverage for children and adults in rural areas and small towns. Republicans in the House are reportedly discussing (here and here) cutting federal Medicaid spending by up to $2.3…
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Cuts to Medicaid Will Shift Costs to Families, Providers and Will Be Especially Harmful to Rural Communities
Medicaid is the backbone of many aspects of our health care system including paying for the majority of nursing home residents, covering 40 to 50 percent of children and births depending on where you live, people with disabilities and other low-income people. Medicaid covers almost 80 million people in total – roughly four times as…
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House Republicans Actively Considering Deep and Damaging Cuts to Medicaid
As we have previously written, since the November election, Congressional Republican leaders have been increasingly open about their intent to make deeply damaging cuts to Medicaid. Now, at a caucus retreat on January 4th, House Republicans actively discussed policy options to cut federal Medicaid spending — including converting Medicaid to a per capita cap —…
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The Budget Resolution and Reconciliation Process Explained
In early 2021, we wrote about the basic rules for passing legislation in the House versus the Senate and how the budget reconciliation process allows certain legislation to move forward with approval from a simple majority of Senators rather than be subject to the filibuster and the usual three-fifths or 60-vote threshold. Given recent reports…
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Webinar: How Medicaid Works & What’s at Stake in 2025
The Georgetown University Center for Children and Families held a special session of our new Child Medicaid Policy Institute on Tuesday, December 10. The Child Medicaid Policy Institute seeks to educate child health advocates, providers, stakeholders, and policymakers on the fundamentals of the Medicaid program and its importance for children, families, and other low-income individuals.…
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Federal Funding Cuts to Medicaid May Trigger Automatic Loss of Health Coverage for Millions of Residents of Certain States
Despite virtually no discussion of Medicaid during the election, Medicaid is facing proposals for significant reductions in federal funding. My colleague Edwin Park has already detailed some of the discussion around these cuts – which are being considered in service of facilitating an extension of tax breaks, the majority of which would go to the…
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Congressional Republican Leaders Start to Show Their Hand: Draconian Medicaid Cuts on the Agenda for Next Year
I have been warning for months that Medicaid would be on the chopping block if there is a second term of the Trump Administration and if Congressional Republicans win House and Senate majorities in 2025. That is because the Project 2025 blueprint, the fiscal year 2025 Republican Study Committee budget plan, and the fiscal year…
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New Federal Funding Opportunity for State Medicaid and CHIP Programs to Support Continuity of Care for Justice-Involved Individuals
Last week, many in the Medicaid and CHIP community were focused on CMS’s announcement of guidance to states on Medicaid EPSDT requirements (and for good reason). However, we also wanted to make sure folks saw the new notice of funding opportunity for planning grants to state Medicaid and CHIP agencies to develop operational capabilities to…
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GOP Push to Make Trump Tax Cuts Permanent Makes Medicaid Top Target for Draconian Cuts
I have been writing about the many conservative and Congressional Republican plans and proposals to make draconian cuts to Medicaid. The centerpiece of several prominent plans — Project 2025, the Republican Study Committee fiscal year 2025 (RSC) budget and the fiscal year 2025 House GOP budget resolution — is to cap and deeply cut federal…
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North Carolina Finds Innovative New Way to Provide Families with Needed Medical Debt Relief
As a nonprofit health attorney over a decade ago I worked in North Carolina on pushing hospital systems to eliminate the practice of suing lower income patients for medical debt and associated abuses like pursuing liens against the houses of poor families. A Pulitzer-prize nominated newspaper series detailed the situation at the time in North…
