What is “Per Capita Cap” Financing in Medicaid and How Would It Work?

The House GOP health care plan released this week proposes a broad range of changes to Medicaid, including a “per capita cap” approach to program financing or a block grant, based on state choice. A new issue brief from the Kaiser Family Foundation provides an overview of how a per capita cap financing structure could work, including implications for the federal government, state governments, beneficiaries and health care providers.

In addition to explaining how a per capita cap approach differs from current law, the Foundation’s new brief examines Medicaid per capita cap provisions included in two other Republican proposals — the House Budget Resolution, and the Health Accessibility, Empowerment and Liberty Act of 2016 (the HAELA bill).