Provider Donations and Assessments: Options for Funding State Costs of Medicaid Expansion

Prepared for the Robert Wood Johnson Foundation State Health Reform Assistance Network

With the federal matching rate for the cost of Medicaid expansion slated to drop in 2017 to 95%, expansion states, as well as states now evaluating expansion, are increasingly focused on the sources of funding for the non-federal share of Medicaid payments for the expansion population. In a new issue brief prepared for the State Health Reform Assistance Network, Manatt Health examines two revenue sources that states may use to fund the non-federal share of Medicaid expansion: provider assessments and provider donations. Both are authorized by federal law and have been used by states in connection with Medicaid expansion.

The issue brief summarizes the rules governing the use of provider assessments and provider donations. It also highlights states' current use of these funding mechanisms.

"Provider Donations and Assessments" is the latest issue brief in an ongoing series examining the fiscal implications of Medicaid expansion. Earlier briefs have analyzed the budget savings and revenue gains realized in expansion states, as well as investigated the impact of expansion on uncompensated care and criminal justice-related costs.

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