Since Medicaid’s enactment in 1965, the federal and state governments have jointly financed the program, with the federal government reimbursing states for a percentage of their Medicaid expenditures. This presentation offers an overview of Medicaid financing as well as certain proposed alternatives and their possible effects—including the potential to reduce federal and state outlays—and related policy and technical issues. MACPAC plans to develop a more detailed analysis of Medicaid financing.