Ending Medicaid Discrimination Against the Most Vulnerable Act

Lower federal match for expansion adults

This bill would phase down the extra federal Medicaid match for expansion adults. From 2027 to 2034, a state’s rate would drop each year by equal steps: (90% minus the state’s FY2026 regular FMAP) divided by 8. If the state’s normal FMAP is higher than the phased amount, the higher normal rate would apply. In 2035 and after, the state would use its regular FMAP. Non‑expansion states would not face this phase‑down after 2024; if they expand later, they would get only the regular FMAP. Expansion states could choose to cover only adults up to 100% of the poverty line and keep the 90% match for that group. The temporary bonus match for late expanders would be repealed on enactment. If passed, states could respond by tightening eligibility, reducing benefits, or raising cost‑sharing for low‑income adults.