HR3321-119

Introduced

To amend title XIX of the Social Security Act to phase out the enhanced Federal match applicable to medical assistance provided to low-income adults.

119th Congress Introduced May 9, 2025

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

The bill provides phases out the enhanced federal matching rate (90%) for Medicaid expansion populations over 8 years (2027-2034), eventually reverting to each state's regular FMAP rate. It relies on appropriations and exemptions. The main policy areas are Healthcare and Finance.

Who Benefits and How

Federal government (HHS/CMS) could see lower costs.

Who Bears the Burden and How

State governments in Medicaid expansion states could face higher costs, Low-income adults in Medicaid expansion states (100-138% FPL) could face increased risk, and Federally Qualified Health Centers (FQHCs) serving expansion populations could lose revenue opportunities.

Key Provisions

  • Provides phases out the enhanced federal matching rate (90%) for Medicaid expansion populations over 8 years (2027-2034), eventually reverting to each state's regular FMAP rate.

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

The bill provides phases out the enhanced federal matching rate (90%) for Medicaid expansion populations over 8 years (2027-2034), eventually reverting to each state's regular FMAP rate.

Key Policy Areas

Healthcare, Finance

Primary Purpose

The bill provides phases out the enhanced federal matching rate (90%) for Medicaid expansion populations over 8 years (2027-2034), eventually reverting to each state's regular FMAP rate.

Policy Domains

Healthcare Finance

Section 2 - Phase-out of enhanced Federal match

Identified Gains
  • Federal government (HHS/CMS)
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
Federal government (HHS/CMS):
Identified Costs
  • State governments in Medicaid expansion states
  • Low-income adults in Medicaid expansion states (100-138% FPL)
  • Federally Qualified Health Centers (FQHCs) serving expansion populations
  • State governments in non-expansion states
  • Health insurance companies (Medicaid managed care organizations)
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
State governments in non-expansion states:
State governments in Medicaid expansion states:
Low-income adults in Medicaid expansion states (100-138% FPL):
Health insurance companies (Medicaid managed care organizations):
Federally Qualified Health Centers (FQHCs) serving expansion populations:

Legislative Progress

Introduced
Introduced Committee Passed
May 9, 2025

Mr. Roy (for himself, Mr. Fitzgerald, Mr. Gill of Texas, …

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

State & Local Government
2 mentions across 1 clause
-2 negative

State governments in Medicaid expansion states, State governments in non-expansion states

Healthcare Beneficiaries
1 mention across 1 clause
-1 negative

Low-income adults in Medicaid expansion states (100-138% FPL)

Community Health Centers
1 mention across 1 clause
-1 negative

Federally Qualified Health Centers (FQHCs) serving expansion populations

Government
1 mention across 1 clause
+1 positive

Federal government (HHS/CMS)

Financial Services
1 mention across 1 clause
-1 negative

Health insurance companies (Medicaid managed care organizations)

1/2
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Finance
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

4 terms
"applicable number of percentage points" §2(1)(F)

The difference between 90% and the state's regular FMAP rate for fiscal year 2026, divided by 8 (representing the 8-year phase-out period from 2027-2034)

"expansion State" §2(4)(B)(i)

A State that is not a non-expansion State (i.e., a state that has expanded Medicaid to cover individuals described in section 1902(a)(10)(A)(i)(VIII) before enactment)

"non-expansion State" §2(4)(B)(ii)

A State that has not expended amounts for all individuals described in section 1902(a)(10)(A)(i)(VIII) before the date of enactment (i.e., states that did not expand Medicaid under the ACA)

"newly eligible individuals" §1902(a)(10)(A)(i)(VIII)

Low-income adults made eligible for Medicaid under the Affordable Care Act expansion (typically adults with incomes up to 138% of the federal poverty line)

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology