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Medicaid Fiscal Accountability Rule Threatens Access to Care, State Budgets

In November 2019, the Centers for Medicare & Medicaid Services (CMS) proposed the Medicaid Fiscal Accountability Regulation (MFAR), which would severely limit states’ flexibility to pay for their share of Medicaid spending. The rule would:

  • threaten the stability of state budgets;
  • significantly narrow and weaken Medicaid; and
  • inevitably deny access to care for millions of Americans.

Medicaid is fundamental to the health care safety net. Millions of working Americans and families rely on the program to meet their health care needs. The MFAR would intrude on the state role in Medicaid by granting the federal government broad and arbitrary discretion to restrict how states finance their program. At risk are congressionally sanctioned, long-standing, regulated local sources of the nonfederal share, such as intergovernmental transfers, certified public expenditures, and provider assessments.

Read our full position paper for details, including a table that outlines the restrictions and impact the MFAR could have on Medicaid funding.

Read Our View – Medicaid Fiscal Accountability Rule Threatens Access to Care, State Budgets


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