States Face Medicaid Funding Crisis Amid Federal Cuts

Voters in Missouri, Oklahoma, and South Dakota have amended their state constitutions to require Medicaid expansion, ensuring coverage for low-income adults under the Affordable Care Act. However, Republican lawmakers in Congress are considering proposals to significantly cut federal Medicaid funding, including reducing the federal match rate from 90% to as low as 50%, which could create substantial budget shortfalls for these states. Unlike nine other states with automatic rollback laws, these three states cannot easily scale back or restrict Medicaid eligibility due to their constitutional amendments. If federal cuts proceed, states would need to find hundreds of billions in new funding or face difficult budget decisions, potentially impacting healthcare services and state finances. The situation poses a political and fiscal dilemma, as states are unable to respond with typical cost-saving measures like work requirements or eligibility rollbacks. Experts warn that such funding cuts could endanger local hospitals and essential health services.