What are Medicaid Per Capita Caps?
Like Medicaid block grants, Medicaid per capita caps would reduce the federal government's obligation to cover Medicaid costs over time. According to the Kaiser Family Foundation, per capita caps would cap the federal government's Medicaid spending per enrollee. Under such a plan, the federal government would select a base year of per enrollee spending then gradually increase that amount over time. The caps could apply to all enrollees, or could be differentiated for separate groups of people covered by Medicaid, such as children, adults, older adults, and people with disabilities. In order to reduce federal Medicaid spending, the federal government would increase the per enrollee spending slower than would be anticipated under current law. Unlike Medicaid block grants, this approach would adjust for enrollment increases, but would not keep pace with increased health care costs that would increase per enrollee spending.
Please see the very helpful visual from the Kaiser Family Foundation below to understand how a per capita cap system would operate over time.
Like Medicaid block grants, Medicaid per capita caps would reduce the federal government's obligation to cover Medicaid costs over time. According to the Kaiser Family Foundation, per capita caps would cap the federal government's Medicaid spending per enrollee. Under such a plan, the federal government would select a base year of per enrollee spending then gradually increase that amount over time. The caps could apply to all enrollees, or could be differentiated for separate groups of people covered by Medicaid, such as children, adults, older adults, and people with disabilities. In order to reduce federal Medicaid spending, the federal government would increase the per enrollee spending slower than would be anticipated under current law. Unlike Medicaid block grants, this approach would adjust for enrollment increases, but would not keep pace with increased health care costs that would increase per enrollee spending.
Please see the very helpful visual from the Kaiser Family Foundation below to understand how a per capita cap system would operate over time.
Additional Informational Resources on Medicaid Per Capita Caps
Center on Budget and Policy Priorities report on how Medicaid per capita caps would adversely affect beneficiaries and state budgets.
Center on Budget and Policy Priorities report on how Medicaid per capita caps would adversely affect beneficiaries and state budgets.
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