The Trump administration wants to dramatically alter the way the federal government gives money to states for Medicaid.
On Thursday, Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, announced a new pathway for states to receive a capped amount of federal dollars for part of the program. The new demonstration program, called Healthy Adult Opportunity, would not be mandatory for states and would not affect all Medicaid beneficiaries, only adults under age 65 who are not disabled.
But for states that adopt the new approach, it could profoundly reshape how Medicaid operates.
Medicaid covers health care for 71 million people across the country — most are low-income people, disabled people, and children. It’s set up as a federal-state partnership — a state contributes money to cover its Medicaid population, and the federal government matches that contribution using a formula based on a state’s per capita income. Therefore, low-income states get more from the federal government than high-income states do.