Forum Session

The Federal-State Medicaid Match: An Ongoing Tug-of-War over Practice and Policy
December 15, 2000


Karen Matherlee


This Forum session explored federal-state Medicaid upper payment limit matching fund issues that led to the Health Care Financing Administration's issuance of a proposed rule on October 10, 2000. Taking into account the history of the issue, particularly with regard to provider taxes and donations, the meeting looked at states' making excessive payments — through so-called intergovernmental transfers — to non-state-owned or -operated public health facilities in order to increase their federal matching dollars. The session examined what was at stake, how HCFA was addressing it, what kinds of approaches states were taking, how Congress has gotten involved, and what the outlook was for the future.


Timothy Westmoreland, Director, Center of Medicaid and State Operations, Health Care Financing Administration; Kathryn G. Allen, Director, Health Care — Medicaid and Private Health Insurance Issues, U.S. General Accounting Office; Ann Patla, Director, Department of Public Aid, State of Illinois

Related Materials

More information available in the accompanying publication, Issue Brief No. 760.

For more recent information on this topic, see "Medicaid Financing: How the FMAP Formula Works and Why It Falls Short" (Issue Brief No. 828, December 11, 2008), and "The Federal-State Struggle over Medicaid Matching Funds: An Update (Background Paper, May 31, 2002).

See also "Medicaid Financing" (The Basics, January 5, 2016).

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