Concerns about the level and rate of growth in federal Medicaid expenditures have generated proposals in Congress to alter the trajectory of Medicaid spending. Given that under the current system of financing federal spending is largely driven by state action, some federal policymakers have been interested in approaches that would reduce the availability of federal funds.
This slide set reviews the most common designs of alternative financing legislation—block grants, per capita caps, and capped allotments (described in greater detail in the June 2016 Report to Congress on Medicaid and CHIP )—and provides an overview of three recent proposals based on these concepts.