RS21262
Federal Medical Assistance Percentage (FMAP) for Medicaid
February 17, 2004

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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 Medicaid 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 FY2004, state FMAPs range from 50% to 77%; that is, the federal government's share of Medicaid costs for FY2004 ranges from 50% to 77% depending on the state. The current fiscal situation of the states has focused attention on Medicaid costs. In the 107th Congress legislation to increase the FMAP passed the Senate. Legislation was introduced in the House but did not pass. In the 108th Congress legislation has been introduced to increase the FMAP for FY2003 and FY2004 (H.R. 816, H.R. 1593, H.R. 2000, S. 10, S. 106, S. 138, S. 414, S. 565, and S. 1012), or alter specific state FMAPs (H.R. 675, H.R. 2716, and S. 294). The budget reconciliation bill, H.R. 2 (P.L. 108-27) contained a provision for temporary fiscal relief to states that includes increased payments under Medicaid. H.R. 2854 (P.L. 108-74) clarified the reinstatement requirements for states related to the higher FMAP payments under P.L. 108-27. This report will be updated as legislative activities warrant.