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Options to Generate the State Share of Medicaid Expansion Costs


In 2020, states that expanded Medicaid will be required to pay for 10 percent of the program’s costs, with the federal government picking up the remaining 90 percent of the costs of Medicaid expansion. While the federal share for Medicaid expansion is considerably higher than federal payments for Medicaid generally, and Medicaid expansion states have seen a positive effect on their economies, states must determine how to generate the 10 percent state share.

This short analysis identifies different strategies that Medicaid expansion states used to pay for the state share in 2018 – when the state share was 6 percent —and how states plan to generate the state share in subsequent years.

This fact sheet provides an analysis of the various strategies states utilize to generate the state share – the 10 percent- of the costs of expanding Medicaid.

It is part of the Medicaid Expansion Leadership Team’s Medicaid Expansion Toolkit.