“The federal government and the states jointly finance Medicaid.51 The federal government reimburses states for a portion (i.e., the federal share) of each state’s Medicaid program costs. Because federal Medicaid funding is an open-ended entitlement to states, there is no upper limit or cap on the amount of federal Medicaid funds a state may receive. In FY2019, Medicaid expenditures totaled $627 billion. The federal share totaled $405 billion and the state share was $222 billion.52“
Source: Alison Mitchell, et al. Medicaid: An Overview. CRS R43357. Congressional Research Service: Washington, DC, updated Feb 22, 2021.
“The federal government’s share of most Medicaid expenditures is established by the federal medical assistance percentage (FMAP) rate, which generally is determined annually and varies by state according to each state’s per capita income relative to the U.S. per capita income.53 The formula provides higher FMAP rates, or federal reimbursement rates, to states with lower per capita incomes, and it provides lower FMAP rates to states with higher per capita incomes.
“FMAP rates have a statutory minimum of 50% and a statutory maximum of 83%.54 For a state with an FMAP of 60%, the state gets 60 cents back from the federal government for every dollar the state spends on its Medicaid program. In FY2021, FMAP rates range from 50% (13 states) to 77.76% (Mississippi).55
“During the COVID-19 public health emergency period, the Family First Coronavirus Response Act (FFCRA; P.L. 116-127) provides a 6.2-percentage-point increase to the regular FMAP rates for all states, the District of Columbia, and the territories that meet certain conditions.56 The FFCRA FMAP increase began on January 1, 2020 (the first day of the calendar quarter in which the COVID-19 public health emergency period began), and the FFCRA FMAP increase is set to end on the last day of the calendar quarter in which the COVID-19 public health emergency period ends.57“
Source: Alison Mitchell, et al. Medicaid: An Overview. CRS R43357. Congressional Research Service: Washington, DC, updated Feb 22, 2021.
Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.
Page last updated March 15, 2021 by Doug McVay, Editor.
