{"id":34420,"date":"2025-05-01T16:23:33","date_gmt":"2025-05-01T20:23:33","guid":{"rendered":"https:\/\/advisory.avalerehealth.com\/?p=34420"},"modified":"2025-05-01T16:58:27","modified_gmt":"2025-05-01T20:58:27","slug":"white-paper-medicaid-reforms-impact-on-funding-for-childrens-healthcare","status":"publish","type":"post","link":"https:\/\/advisory.avalerehealth.com\/insights\/white-paper-medicaid-reforms-impact-on-funding-for-childrens-healthcare","title":{"rendered":"White Paper: Medicaid Reforms\u2019 Impact on Funding for Children\u2019s Healthcare"},"content":{"rendered":"

Download the white paper.<\/span>\u00a0<\/span><\/a><\/p>\n

The 119th Congress is considering reforms aimed at reducing federal Medicaid spending as part of broader budget deliberations. In 2023, the federal government<\/a> spent $637 billion on Medicaid, and the program accounted<\/a> for around one in five healthcare dollars spent in the US.<\/p>\n

Given this discussion, Avalere Health modeled the impact of three policy options that would reduce federal Medicaid spending by changing the program\u2019s funding structure. Avalere Health defined the parameters of each modeled policy; they are not based on budgetary language.<\/p>\n

For each of the policies, we assess the overall impact on federal program funding and anticipated changes to federal funding for services provided to children (i.e., through the impact of a per capita cap on beneficiaries who are children or through reduced federal matching funds for children\u2019s services), both nationally and at the state level.<\/p>\n

Avalere Health modeled the following three scenarios:<\/p>\n

    \n
  1. Implementation of a per capita cap on Medicaid spending<\/li>\n
  2. Federal Medical Assistance Percentage (FMAP) reduction for the Affordable Care Act Medicaid expansion population<\/li>\n
  3. Removal of the 50% FMAP floor<\/li>\n<\/ol>\n

    Findings<\/strong><\/p>\n

    The modeled policies would result in total federal funding cuts of $436\u2013779 billion over ten years and include reductions in federal Medicaid funding for children between $57 and $114 billion.<\/p>\n

    Table 1. Projected change in total federal Medicaid funding and federal Medicaid funding to children under each scenario (2025\u20132034) <\/strong><\/p>\n

    \"\"<\/p>\n

    CPI-U: Consumer Price Index for All Urban Consumers; CPI-M: Consumer Price Index for Medical Care \u2020 <\/sup>Results do not include a breakout on funding for children because children are not part of the expansion population. *Percent change reflects the change in federal funding for the Medicaid expansion population only. **Percent change reflects the change in federal funding for the non-expansion population nationwide.<\/em><\/p>\n

    As modeled, per capita caps would impact all states (with total federal funding reductions of 5\u20137% per state), whereas the FMAP floor removal would impact 10 states and DC (4\u201352% federal funding reduction per state for non-expansion enrollees; 100% for DC). A change to expansion FMAP would impact 40 states and DC with Medicaid expansions (18\u201344% federal funding reduction per state for expansion enrollees).<\/p>\n

    As Congress considers various policy options, it is important to consider the effect on Medicaid funding by state and on specific populations, including children. Any change that reduces federal funding would require states to contribute more state funds to Medicaid or reduce Medicaid spending.<\/p>\n

    Download the free white paper<\/a>.<\/p>\n

    Funding for this research was provided by the Children\u2019s Hospital Association. Avalere Health retained full editorial control.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    Download the white paper.\u00a0 The 119th Congress is considering reforms aimed at reducing federal Medicaid spending as part of broader budget deliberations. In 2023, the federal government spent $637 billion on Medicaid, and the program accounted for around one in five healthcare dollars spent in the US. Given this discussion, Avalere Health modeled the impact…<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3],"tags":[],"content-categories":[1023],"class_list":["post-34420","post","type-post","status-publish","format-standard","hentry","category-insights","content-categories-coverage-and-payment","entry","no-media"],"acf":[],"yoast_head":"\nWhite Paper: Medicaid Reforms\u2019 Impact on Funding for Children\u2019s Healthcare | Avalere Health Advisory<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/advisory.avalerehealth.com\/insights\/white-paper-medicaid-reforms-impact-on-funding-for-childrens-healthcare\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"White Paper: Medicaid Reforms\u2019 Impact on Funding for Children\u2019s Healthcare | Avalere Health Advisory\" \/>\n<meta property=\"og:description\" content=\"Download the white paper.\u00a0 The 119th Congress is considering reforms aimed at reducing federal Medicaid spending as part of broader budget deliberations. In 2023, the federal government spent $637 billion on Medicaid, and the program accounted for around one in five healthcare dollars spent in the US. Given this discussion, Avalere Health modeled the impact…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/advisory.avalerehealth.com\/insights\/white-paper-medicaid-reforms-impact-on-funding-for-childrens-healthcare\" \/>\n<meta property=\"og:site_name\" content=\"Avalere Health Advisory\" \/>\n<meta property=\"article:published_time\" content=\"2025-05-01T20:23:33+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-05-01T20:58:27+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/advisory.avalerehealth.com\/wp-content\/uploads\/2025\/05\/5.1.-25-medicaid-table.png\" \/>\n\t<meta property=\"og:image:width\" content=\"945\" \/>\n\t<meta property=\"og:image:height\" content=\"422\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Leah Keller\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:site\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Leah Keller\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"White Paper: Medicaid Reforms\u2019 Impact on Funding for Children\u2019s Healthcare | Avalere Health Advisory","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/advisory.avalerehealth.com\/insights\/white-paper-medicaid-reforms-impact-on-funding-for-childrens-healthcare","og_locale":"en_US","og_type":"article","og_title":"White Paper: Medicaid Reforms\u2019 Impact on Funding for Children\u2019s Healthcare | Avalere Health Advisory","og_description":"Download the white paper.\u00a0 The 119th Congress is considering reforms aimed at reducing federal Medicaid spending as part of broader budget deliberations. 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Keller","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/advisory.avalerehealth.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/4a87f9cf63da84fab5720429686278df?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/4a87f9cf63da84fab5720429686278df?s=96&d=mm&r=g","caption":"Leah Keller"},"description":"Leah Keller co-manages and edits the Policy 360 Research Series sits on Avalere\u2019s Marketing Team. Prior to joining Avalere, Leah conducted policy research and analysis on federal healthcare issues such as Medicaid coverage and payment, commercial insurance coverage and access, healthcare reform, and ACA implementation at the Guttmacher Institute, a thinktank focused on advancing reproductive health and rights. Prior, Leah coordinated data collection, analysis, and publications for George Washington University\u2019s Center for Social Well-Being and Development. Leah holds an MPH in maternal and child health from George Washington University and a BA in anthropology from St. Mary\u2019s College of Maryland.","url":"https:\/\/advisory.avalerehealth.com\/author\/lkelleravalere-com"}]}},"_links":{"self":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts\/34420","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/comments?post=34420"}],"version-history":[{"count":5,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts\/34420\/revisions"}],"predecessor-version":[{"id":34434,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts\/34420\/revisions\/34434"}],"wp:attachment":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/media?parent=34420"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/categories?post=34420"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/tags?post=34420"},{"taxonomy":"content-categories","embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/content-categories?post=34420"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}