GOP Rep. Austin Scott gave away the game during an interview on Fox Business Network this Monday, while pretending their plan won't end up causing people to lose coverage.
April 24, 2025

GOP Rep. Austin Scott gave away the game during an interview on Fox Business Network this Monday, while pretending their plan won't end up causing people to lose coverage.

Here's the exchange with Scott and Mornings with Maria guest host Cheryl Casone:

CASONE: So Congressman, the White House seems very confident they're going to get this one big beautiful bill despite a lot of different comments coming from some of your colleagues in the House.

SCOTT: Yeah, well, let's talk about what, Medicaid and FMAP is, and the intentional confusion here from the, from the left.

So, FMAP is the federal medical assistance percentage, and it ranges from 50 percent in the country to 76.9 percent.

Now when the, when the Dems expanded Medicaid under the Affordable Care Act, they made that percentage match 90/10, so the federal government is paying 90 percent of the Medicaid expansion.

And so what we have talked about is moving that 90 percent level of the expansion back towards the more traditional levels of 50 to approximately 80 percent, instead instead of the 90/10, 90 percent being federal, 10 being being state match.

That that's what we've talked about and nobody would be kicked off of Medicaid as long as the Governors decided that they wanted to continue to fund the program.

And so we, we are going to ask the states to pick up and pay some additional percentage of the Medicaid percentage, more than the 10 percent, and it's amazing.

You would think that these liberal governors around the country would be be champing at the bit, and offering to pay more than than 10 percent if they thought the program was important.

But we, we have talked about changing that formula and Medicaid expansion that the Democrats did, which is 90 percent fed, 10 percent state, to more closely align with what the traditional match is, which ranges between 50 percent for wealthy states and about 75 percent for some of the lower income states.

CASONE: No, and I appreciate the clarification because you know when you hear that that Medicaid is being targeted, in a general sense, I agree with you that we need to, so thank you for telling us that those discussions are actually underway.

SCOTT: Medicare, they've said Social Security, those are both boldfaced lies and now, and now they're absolutely misrepresenting the Medicaid scenario.

We are going to ask the states to pay a larger percentage of the Medicaid.

Marin Scotten at The New Republic explained what this will mean for the states:

House Republicans are trying to drastically cut Medicaid coverage and blame it all on the states.

When Democrats expanded Medicaid coverage under President Barack Obama’s Affordable Care Act to include adults with incomes of up to 138 percent of the poverty level, states that implemented the expansion received a 90 percent federal medical assistance percentage, or FMAP, from the federal government. That means the federal government covers 90 percent of the costs for those enrolled in the ACA expansion, and the state covers 10 percent.

The GOP wants to drastically decrease the federal match rate for the ACA expansion and shift more financial responsibility to states, Republican Representative Austin Scott told Fox Business Tuesday. [...]

The cut would be devastating to the 20 million Americans who currently rely on the expansion for health insurance coverage—many of whom reside in red states—and would leave some 40 states that have adopted the ACA expansion to fend for themselves with their limited budgets. [...]

According to an analysis from the health nonprofit KFF, if states had to pay a higher match-rate percentage, many would likely abandon the ACA program altogether, resulting in millions of lost coverage for low-income Americans. Twelve states currently have laws in place that would end the expansion immediately or require immediate changes if the federal match rate were to drop, KFF pointed out.

Here's more from the article at KFF:

What are the potential impacts on Medicaid spending and enrollment?

This analysis does not make assumptions about specific state behavioral responses and instead examines the impact of eliminating the ACA expansion match rate under two scenarios. These scenarios are designed to illustrate the range of potential policy change effects; in practice, each state may respond to the policy change differently. While some states may choose to continue ACA Medicaid expansion coverage with substantially reduced federal funding, many likely would not given the extra spending that would be required. The analysis also excludes secondary effects such as people who lose coverage through the Medicaid expansion enrolling in Medicaid under other eligibility pathways or enrolling in private health coverage. The estimates presented here are not directly comparable to the estimates of federal savings from the Congressional Budget Office (CBO) because CBO’s estimates account for assumptions about state behavioral responses and other secondary effects.

  • Scenario 1: All expansion states pick up new expansion costs. Expansion enrollment and total spending would remain constant while costs shift from the federal government to the states.
  • Scenario 2: All states drop the ACA Medicaid expansion, resulting in changes to enrollment as well as total, federal, and state spending.

Eliminating the enhanced FMAP for adults in the Medicaid expansion could reduce Medicaid spending by nearly one-fifth ($1.9 trillion) over a 10-year period and up to nearly a quarter of all Medicaid enrollees (20 million people) could lose coverage. Under scenario 1, federal Medicaid spending would decrease by $626 billion or 10% across all states over the 10-year period, with the federal government providing matching funds at the standard rate rather than 90%. If all states picked up those costs and retained the Medicaid expansion, that would mean an additional $626 billion in state spending or a 17% increase in state spending across all states over the 10-year period. Under scenario 2, all state and federal financial support for Medicaid expansion is withdrawn, resulting in a $1.7 trillion dollar or 25% cut to federal Medicaid spending and a $186 billion dollar or 5% cut to state Medicaid spending across all states, including non-expansion. Combined, Medicaid spending would decrease by 18% or $1.9 trillion over the 10-year period. The cuts are even larger when looking among expansion states alone, resulting in a 31% decline in federal spending, a 6% decline in state spending, and a 22% decline in total spending. Under this scenario, an estimated 20 million Medicaid enrollees eligible through expansion would lose coverage, decreasing total Medicaid enrollment by 24% (by year 10).

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