Concerns about the level and rate of growth in federal Medicaid expenditures—which have increased from 1.4 percent of federal outlays in fiscal year (FY) 1970 to 9.5 percent in FY 2015—have prompted some policymakers to consider changes that would significantly alter the trajectory of spending.
This presentation covers two draft chapters of MACPAC’s June 2016 report to Congress. Chapter 2 reviews Medicaid’s current financing structure, and discusses familiar proposals to limit federal spending in Medicaid and the key design decisions associated with each. Chapter 3 discusses options states have under current authority to control spending and deliver care more efficiently. It also touches on state requests for increased flexibility to accomplish these aims.