Download Locations

• Open CRS (User submitted)

Summary

Medicaid is a health insurance program jointly funded by the federal government and the states. Generally, eligibility for Medicaid is limited to low-income children, pregnant women, parents of dependent children, the elderly, and people with disabilities. The federal government's share of a state's expenditures for most Medicaid services is called the federal medical assistance percentage (FMAP). Determined annually, the FMAP is designed so that the federal government pays a larger portion of Medicaid costs in states with lower per capita income relative to the national average (and vice versa for states with higher per capita incomes). For FY2008, FMAPs range from 50.00% to 76.29%. For FY2009, FMAPs range from 50.00% to 75.84%. In recent years, the fiscal situation of the states has focused attention on Medicaid expenditures, as well as on changes in the federal share, or FMAP. In the 108th Congress, the Jobs and Growth Tax Relief Reconciliation Act of 2003 (JGTRRA, P.L. 108-27) provided temporary fiscal relief for states and local governments through a combination of FMAP increases and direct grants. In the 109th Congress, provisions to exclude certain Hurricane Katrina evacuees and their incomes from FMAP calculations and prevent Alaska's FY2006-FY2007 FMAPs from decreasing were included in the Deficit Reduction Act of 2005 (P.L. 109-171). In the 110th Congress, a temporary FMAP increase was included in economic stimulus legislation that was debated but not adopted at the end of 2008. In the 111th Congress, a temporary FMAP increase is currently under consideration in the House and Senate as part of the American Recovery and Reinvestment Act of 2009. The House passed its version as part of H.R. 1 on January 28, 2009. The Senate Finance Committee reported its own version of a temporary FMAP increase on January 27, with consideration by the full Senate expected the first week in February. Although the House-passed and Senate Finance versions are broadly similar, they differ on the degree to which funds are targeted at states experiencing unemployment rate increases and whether the temporary FMAP increase applies to expenditures for individuals who are eligible for Medicaid because of an increase in a state's income eligibility standards. Preliminary estimates from the Congressional Budget Office indicate that over five years, the House-passed version would increase federal spending by $87.7 billion and the Senate Finance version would increase federal spending by $86.6 billion.

Related Legislation:
• H.R.1

XML - JSON