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Reformulating the Federal Match as a Key to the Sustainability of Medicaid

Stephen W. Patrick, MD, MPH, MS; Matthew M. Davis, MD, MAPP
JAMA Pediatr. 2013;167(3):218-220. doi:10.1001/jamapediatrics.2013.1075.
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The recent so-called “great recession” highlighted both the importance of Medicaid to our nation's vulnerable populations and the financial burden of Medicaid on state governments. For the more than 51 million individuals with Medicaid coverage (among them, 26 million children), the program makes access to health care services affordable.1 However, the ever-increasing costs of health care and recent rapid enrollment growth in Medicaid for children, disabled adults, and elderly adults1 make Medicaid progressively unaffordable and fiscally unsustainable for states that must balance their annual budgets.

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Figure. Variation across states in the relative difference of total taxable resources (TTR) vs per capita income (PCI) in 2009. The District of Columbia is not shown because its Federal Medical Assistance Percentage is set independently. The horizontal line indicates the 30% mean relative difference between TTR and PCI across states.

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