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Analysts Warn Federal Medicaid Changes Could Force Large State Budget Cuts
Summary
A Department of Legislative Services briefing outlined multiple federal policy changes that could shrink federal Medicaid funding for Maryland — including block grants, reduced enhanced matching funds and narrower eligibility — and provided state-level dollar estimates for some scenarios.
Anne Braun, an analyst with the Department of Legislative Services, told the Appropriations Committee that several federal policy options under discussion could substantially change how Medicaid is funded and administered and that the effect on Maryland’s budget is uncertain.
“These are possible changes that might be made, but the effect on Maryland is still very uncertain,” Braun said, emphasizing the figures in her presentation were estimates rather than predictions.
Braun gave a quick primer on Medicaid’s financing and use in Maryland: Medicaid is a joint federal–state entitlement; the state typically receives a roughly 50 percent federal match for Medicaid spending but some programs receive higher rates. She said Maryland’s Medicaid enrollment was 1.35 million people as of December 2024, including about 500,000 children. The Maryland Children’s Health Program had about 185,000 enrollees as of December 2024 and, she said, receives a roughly 65…
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