Medicaid Financing: How Does it Work and What are the Implications?

Table 1: Special Federal Matching Percentages (FMAPs)
Service/Population FMAP
Special FMAPs Enacted under the ACA
Newly eligible, non-disabled adults under age 65 up to 138% FPL1






(1/14 – 12/16)

(1/17 – 12/17)

(1/18 – 12/18)

(1/19 – 12/19)

(1/20 & beyond)

Health Home Services* 90%
State Balancing Incentive Program (BIP)** State’s FMAP + 5 or 2 percentage points (10/11 – 9/15)
Community First Choice (CFC)*** State’s FMAP + 6 percentage points (10/11 & beyond)
Clinical Preventive Services for Adults State’s FMAP + 1 percentage point (1/13 & beyond)
Special FMAPs Predating the ACA
Breast and Cervical Cancer Treatment State’s CHIP eFMAP rate2
Family Planning Services 90%
Indian Health Service and Tribal Facility Services3 100%
Money Follows the Person Rebalancing Demo MFP-enhanced FMAP***
* These services are matched at the enhanced rate for eight calendar quarters. After that, spending is matched at the state’s standard FMAP. States can adopt multiple Health Home SPAs targeting different populations at different times.
** The BIP makes enhanced Medicaid matching funds available to certain states that meet requirements for expanding the share of LTSS spending for HCBS (and reducing the share of LTSS spending for institutional services).

*** States electing the CFC state plan option to provide Medicaid-funded home and community-based attendant services and supports will receive an FMAP increase of six percentage points for CFC services.


Issue Brief