Capitol Correspondence - 01.14.25

Early GOP Proposal Floats Medicaid Changes, Including Per-Capita Caps and Provider Tax Limits

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House Republicans are considering a list of potential spending cuts to fund President-elect Donald Trump’s domestic policy priorities, including significant changes to Medicaid. The proposal, still in its early stages and highly undefined, includes per-capita caps on Medicaid funding, limiting provider taxes, reducing the federal medical assistance percentage (FMAP) floor, and repealing enhanced Medicaid funding under the American Rescue Plan Act (ARPA).

The draft proposal reported on by Politico outlines potential cuts totaling up to $2.3 trillion in Medicaid savings over the next decade. These options, while not concrete policy proposals, represent early discussions among GOP lawmakers.

While the document includes these potential changes, it emphasizes that the proposals are a “menu” for consideration, with many elements likely to face strong bipartisan opposition and debate.

ANCOR will continue to advocate for increasing access to Medicaid home and community-based disability services, and we remain vigilant about the potential implications of these proposals. It is important to note that current reporting indicates members are in the very early stages of this discussion and lacks details about how these changes might be implemented. Given the slim Republican majority in Congress, internal GOP divisions, and expected Democratic resistance, the path forward remains uncertain. ANCOR will continue to monitor and provide updates as we have them.