Ending Medicaid Discrimination Against the Most Vulnerable Act

This bill proposes to amend Title XIX of the Social Security Act to systematically phase out the enhanced federal matching funds , known as the Federal Medical Assistance Percentage (FMAP), for medical assistance provided to low-income adults under Medicaid expansion. Currently set at 90 percent, this enhanced FMAP would continue through 2026 before beginning a gradual reduction. Starting in 2027 and continuing through 2034, the enhanced FMAP will decrease annually by a calculated number of percentage points, eventually reverting to the state's standard FMAP by 2035 . A significant provision states that non-expansion states , defined as those that had not fully expanded Medicaid before the bill's enactment, will no longer be eligible for the enhanced federal match after 2024. Furthermore, if a non-expansion state chooses to expand Medicaid after this date, it will only receive the standard FMAP for newly eligible individuals. Conversely, states that have already expanded Medicaid may elect to continue receiving the enhanced FMAP specifically for individuals whose income does not exceed 100 percent of the Federal Poverty Line. The bill also eliminates any temporary FMAP increases for states that might begin to provide medical assistance for low-income adults after its enactment, reinforcing the phase-out of enhanced federal support for new expansions.