Notice2024-27910
Federal Financial Participation in State Assistance Expenditures; Federal Matching Shares for Medicaid, the Children's Health Insurance Program, and Aid to Needy Aged, Blind, or Disabled Persons for October 1, 2025, Through September 30, 2026
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 29, 2024
Effective
October 1, 2025
Issuing agencies
Health and Human Services Department
Abstract
The Federal Medical Assistance Percentages (FMAP), Enhanced Federal Medical Assistance Percentages (eFMAP), and disaster-recovery FMAP adjustments for fiscal year 2026 have been calculated pursuant to the Social Security Act (the Act). These percentages will be effective from October 1, 2025, through September 30, 2026. This notice announces the calculated FMAP rates, in accordance with the Act, that the U.S. Department of Health and Human Services (HHS) will use in determining the amount of Federal matching for state medical assistance (Medicaid), Temporary Assistance for Needy Families (TANF) Contingency Funds, Child Support collections, Child Care Mandatory and Matching Funds of the Child Care and Development Fund, Title IV-E Foster Care Maintenance payments, Adoption Assistance payments and Kinship Guardianship Assistance payments, and the eFMAP rates for the Children's Health Insurance Program (CHIP) expenditures. Table 1 gives figures for each of the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. This notice reminds states of adjustments available for states meeting requirements for disproportionate employer pension or insurance fund contributions and adjustments for disaster recovery. Based on the criteria for a qualifying state, one state meets the requirements for an adjustment for disaster recovery.
Full Text
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<title>Federal Register, Volume 89 Issue 230 (Friday, November 29, 2024)</title>
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[Federal Register Volume 89, Number 230 (Friday, November 29, 2024)]
[Notices]
[Pages 94742-94746]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-27910]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
Federal Financial Participation in State Assistance Expenditures;
Federal Matching Shares for Medicaid, the Children's Health Insurance
Program, and Aid to Needy Aged, Blind, or Disabled Persons for October
1, 2025, Through September 30, 2026
AGENCY: Office of the Secretary, HHS.
ACTION: Notice.
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SUMMARY: The Federal Medical Assistance Percentages (FMAP), Enhanced
Federal Medical Assistance Percentages (eFMAP), and disaster-recovery
FMAP adjustments for fiscal year 2026 have been calculated pursuant to
the Social Security Act (the Act). These percentages will be effective
from October 1, 2025, through September 30, 2026. This notice announces
the calculated FMAP rates, in accordance with the Act, that the U.S.
Department of Health and Human Services (HHS) will use in determining
the amount of Federal matching for state medical assistance (Medicaid),
Temporary Assistance for Needy Families (TANF) Contingency Funds, Child
Support collections, Child Care Mandatory and Matching Funds of the
Child Care and Development Fund, Title IV-E Foster Care Maintenance
payments, Adoption Assistance payments and Kinship Guardianship
Assistance payments, and the eFMAP rates for the Children's Health
Insurance Program (CHIP) expenditures. Table 1 gives figures for each
of the 50 states, the District of Columbia, Puerto Rico, the Virgin
Islands, Guam, American Samoa, and the Commonwealth of the Northern
Mariana Islands. This notice reminds states of adjustments available
for states meeting requirements for disproportionate employer pension
or insurance fund contributions and adjustments for disaster recovery.
Based on the criteria for a qualifying state, one state meets the
requirements for an adjustment for disaster recovery.
DATES: The percentages listed in Table 1 will be effective for each of
the four quarter-year periods beginning October 1, 2025, and ending
September 30, 2026.
[[Page 94743]]
FOR FURTHER INFORMATION CONTACT: Amelia Whitman, Office of Health
Policy, Office of the Assistant Secretary for Planning and Evaluation,
Room 447D--Hubert H. Humphrey Building, 200 Independence Avenue SW,
Washington, DC 20201, (202) 578-1478.
SUPPLEMENTARY INFORMATION: The Secretary of HHS manages programs under
titles IV, XIX and XXI of the Act in each jurisdiction of the United
States. Programs under titles I, X, and XIV of the Act operate only in
Guam and the Virgin Islands, and a program under title XVI of the Act
(Aid to the Aged, Blind, or Disabled) operates only in Puerto Rico. The
percentages in this notice apply to state expenditures for most medical
assistance and child health assistance, and assistance payments for
certain social services provided under these titles. The Act provides
separate terms for Federal matching of administrative costs.
Sections 1905(b) and 1101(a)(8)(B) of the Act require the Secretary
of HHS to publish the FMAP rates each year. The Secretary calculates
the percentages, using formulas set out in sections 1905(b) and
1101(a)(8), and calculations from the Department of Commerce of average
income per person in each state and for the United States (meaning, for
this purpose, the fifty states). The final percentages are subject to
upper and lower limits specified in section 1905(b) of the Act. The
percentages for the District of Columbia, Puerto Rico, the Virgin
Islands, Guam, American Samoa, and the Northern Mariana Islands are
specified in statute, and thus are not based on the statutory formula
that determines the percentages for the 50 states.
Federal Medical Assistance Percentage (FMAP)
Section 1905(b) of the Act specifies the formula for calculating
FMAPs as follows:
``Subject to [statutory qualifications], the term `Federal medical
assistance percentage' for any state shall be 100 per centum less the
state percentage; and the state percentage shall be that percentage
which bears the same ratio to 45 per centum as the square of the per
capita income of such state bears to the square of the per capita
income of the continental United States (including Alaska) and Hawaii;
except that (1) the Federal medical assistance percentage shall in no
case be less than 50 per centum or more than 83 per centum[.]''
Section 1905(b) further specifies that the FMAP for Puerto Rico,
the Virgin Islands, Guam, the Northern Mariana Islands, and American
Samoa shall be 55 percent.
However, section 5101(b) of the Consolidated Appropriations Act,
2023 amended section 1905(ff) of the Act to provide that the FMAP for
the Virgin Islands, Guam, the Northern Mariana Islands, and American
Samoa shall be 83 percent permanently, and that the FMAP for Puerto
Rico shall be 76 percent through September 30, 2027. In addition, we
note that the rate that applies for Puerto Rico, the Virgin Islands,
and Guam in certain other programs pursuant to section 1118 of the Act
is 75 percent. Section 4725(b) of the Balanced Budget Act of 1997
amended section 1905(b) to provide that the FMAP for the District of
Columbia, for purposes of titles XIX and XXI, shall be 70 percent. For
the District of Columbia, we note under Table 1 that other rates may
apply in certain other programs. The rates for the States, the District
of Columbia, and the territories are set out in Table 1, Column 1.
Section 1905(y) of the Act, as added by section 2001(a)(3) of the
Patient Protection and Affordable Care Act of 2010 (``Affordable Care
Act'') (Pub. L. 111-148), provides for a significant increase in the
FMAP for medical assistance expenditures for newly eligible individuals
described in section 1902(a)(10)(A)(i)(VIII) of the Act, as added by
the Affordable Care Act (the adult group); ``newly eligible'' is
defined in section 1905(y)(2)(A) of the Act. The FMAP for the adult
group is 100 percent for Calendar Years 2014, 2015, and 2016, gradually
declining to 90 percent in 2020, where it remains indefinitely. Section
1905 of the Act was further amended by section 9814 of the American
Rescue Plan of 2021 (Pub. L. 117-2) to provide an eight-quarter
increase of five percentage points in a qualifying state or territory's
FMAP for a state or territory that begins to cover the adult group
after March 11, 2021. In addition, section 1905(z) of the Act, as added
by section 10201 of the Affordable Care Act, provides that states that
offered substantial health coverage to certain low-income parents and
nonpregnant, childless adults on the date of enactment of the
Affordable Care Act, referred to as ``expansion states,'' shall receive
an enhanced FMAP beginning in 2014 for medical assistance expenditures
for nonpregnant childless adults who may be required to enroll in
benchmark coverage under section 1937 of the Act. Some of these
provisions are discussed in more detail in the proposed rule,
``Medicaid Program; Eligibility Changes Under the Affordable Care Act
of 2010'', published on August 17, 2011 (76 FR 51148, 51172) and the
final rule and interim final rule published on March 23, 2012 (77 FR
17144, 17194). This notice does not set forth the matching rates for
the adult group as specified in section 1905(y) of the Act or the
matching rates for nonpregnant, childless adults in expansion states as
specified in section 1905(z) of the Act.
Other Adjustments to the FMAP
For purposes of Title XIX (Medicaid) of the Act, the Federal
Medical Assistance Percentage (FMAP), defined in section 1905(b) of the
Act, for each state beginning with fiscal year 2006, may be subject to
an adjustment pursuant to section 614 of the Children's Health
Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-
3.
First, the FMAP is adjusted if a state experiences no growth or
positive growth in total personal income and an employer in that state
has made a significantly disproportionate contribution to an employer
pension or insurance fund. The adjustment involves disregarding the
significantly disproportionate employer pension or insurance fund
contribution in computing the per capita income for the state (but not
in computing the per capita income for the United States). Employer
pension and insurance fund contributions are significantly
disproportionate if the increase in contributions exceeds 25 percent of
the total increase in personal income in that state. A Federal Register
Notice with comment period was published on June 7, 2010 (75 FR 32182)
announcing the methodology for calculating this adjustment; a final
notice was published on October 15, 2010 (75 FR 63480).
The second situation arises if a state experiences negative growth
in total personal income. Beginning with fiscal year 2006, section
614(b)(3) of CHIPRA specifies that, for the purposes of calculating the
FMAP for a calendar year in which a state's total personal income has
declined, the portion of an employer pension or insurance fund
contribution that exceeds 125 percent of the amount of such
contribution in the previous calendar year shall be disregarded in
computing the per capita income for the state (but not in computing the
per capita income for the United States).
No Federal source of reliable and timely data on pension and
insurance contributions by individual employers and states is currently
available. We request that states report employer pension or insurance
fund contributions to help determine potential FMAP adjustments for
states experiencing significantly disproportionate pension
[[Page 94744]]
or insurance contributions and states experiencing a negative growth in
total personal income. See also the information described in the
January 21, 2014 Federal Register notice (79 FR 3385).
Section 1905(aa) of the Act, as amended by section 2006 of the
Affordable Care Act, specifies that notwithstanding section 1905(b) of
the Act, the FMAP for a ``disaster-recovery FMAP adjustment state'' is
adjusted as described in section 1905(aa)(1) of the Act. The statute
defines a ``disaster-recovery FMAP adjustment State'' as one of the 50
states or District of Columbia for which, at any time during the
preceding 7 fiscal years, the President has declared a major disaster
under section 401 of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act, under which every county or parish in the
state warrant individual and public or public assistance from the
Federal Government, and for which the regular FMAP as determined for
the fiscal year is less than the FMAP for the preceding fiscal year by
an amount outlined under sections 1905(aa)(2)(A) and (aa)(2)(B) of the
Act. All states and the District of Columbia had a presidential
disaster declaration that applies to all counties and parishes within
the state in the preceding 7 fiscal years. Section 1905(aa)(3) of the
Act defines a state's ``regular FMAP'' to be the FMAP that would
otherwise apply to the state for the fiscal year, as determined under
section 1905(b) and without regard to section 1905(aa), (y), and (z),
and section 10202 of the Affordable Care Act. One state, Nebraska,
meets the requirement that its regular FMAP as determined for Fiscal
Year 2026 is less than the previous year FMAP by at least three
percentage points (i.e., the amount required under section
1905(aa)(2)(A) for a state's first fiscal year that section 1905(aa)
applies to the state). Therefore, this notice provides a disaster-
recovery FMAP adjustment for the state of Nebraska for Fiscal Year
2026, as shown in Table 2. See more information described in the
December 22, 2010 Federal Register notice (75 FR 80501).
The increased FMAP (with disaster-recovery adjustment) is available
for state medical assistance (Medicaid) and for title IV-E ``Foster
Care, Adoption Assistance and Guardianship Assistance'' programs.
Expenditures for which the increased FMAP is not available under title
XIX include expenditures for disproportionate share hospital payments
and expenditures that are paid at an enhanced FMAP rate, as well as any
payments made under Title XXI.
Enhanced Federal Medical Assistance Percentage (eFMAP) for CHIP
Section 2105(b) of the Act specifies the formula for calculating
the eFMAP rates as follows:
[T]he ``enhanced FMAP'', for a state for a fiscal year, is equal
to the Federal medical assistance percentage (as defined in the
first sentence of section 1905(b)) for the state increased by a
number of percentage points equal to 30 percent of the number of
percentage points by which (1) such Federal medical assistance
percentage for the state, is less than (2) 100 percent; but in no
case shall the enhanced FMAP for a state exceed 85 percent.
The eFMAP rates are used in the Children's Health Insurance Program
under title XXI and in the Medicaid program for expenditures for
medical assistance provided to certain children as described in
sections 1905(u)(2) and 1905(u)(3) of the Act. There is no specific
requirement to publish the eFMAP rates. We include them in this notice
for the convenience of the states (Table 1, Column 2).
(Catalog of Federal Domestic Assistance Program Nos. 93.558: TANF
Contingency Funds; 93.563: Child Support Services; 93.596: Child
Care Mandatory and Matching Funds of the Child Care and Development
Fund; 93.658: Foster Care Title IV-E; 93.659: Adoption Assistance;
93.769: Ticket-to-Work and Work Incentives Improvement Act (TWWIIA)
Demonstrations to Maintain Independence and Employment; 93.778:
Medical Assistance Program; 93.767: Children's Health Insurance
Program)
Dated: November 22, 2024.
Xavier Becerra,
Secretary, Department of Health and Human Services.
Table 1--Federal Medical Assistance Percentages and Enhanced Federal
Medical Assistance Percentages, Effective October 1, 2025-September 30,
2026
[Fiscal year 2026]
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Federal medical Enhanced Federal
State assistance medical assistance
percentages percentages
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Alabama......................... 72.63 80.84
Alaska.......................... 52.42 66.69
American Samoa *................ 83.00 85.00
Arizona......................... 64.34 75.04
Arkansas........................ 69.23 78.46
California...................... 50.00 65.00
Colorado........................ 50.00 65.00
Connecticut..................... 50.00 65.00
Delaware........................ 59.41 71.59
District of Columbia **......... 70.00 79.00
Florida......................... 57.22 70.05
Georgia......................... 66.40 76.48
Guam*........................... 83.00 85.00
Hawaii.......................... 59.68 71.78
Idaho........................... 66.91 76.84
Illinois........................ 51.82 66.27
Indiana......................... 64.74 75.32
Iowa............................ 62.70 73.89
Kansas.......................... 60.67 72.47
Kentucky........................ 71.41 79.99
Louisiana....................... 67.83 77.48
Maine........................... 61.29 72.90
Maryland........................ 50.00 65.00
Massachusetts................... 50.00 65.00
Michigan........................ 65.30 75.71
[[Page 94745]]
Minnesota....................... 50.68 65.48
Mississippi..................... 76.90 83.83
Missouri........................ 64.44 75.11
Montana......................... 61.47 73.03
Nebraska ***.................... 55.94 68.05
Nevada.......................... 59.80 71.86
New Hampshire................... 50.00 65.00
New Jersey...................... 50.00 65.00
New Mexico...................... 71.66 80.16
New York........................ 50.00 65.00
North Carolina.................. 64.62 75.23
North Dakota.................... 50.99 65.69
Northern Mariana Islands *...... 83.00 85.00
Ohio............................ 64.85 75.40
Oklahoma........................ 66.47 76.53
Oregon.......................... 57.75 70.43
Pennsylvania.................... 56.06 69.24
Puerto Rico *................... 76.00 83.20
Rhode Island.................... 57.50 70.25
South Carolina.................. 69.53 78.67
South Dakota.................... 51.01 65.71
Tennessee....................... 64.16 74.91
Texas........................... 59.83 71.88
Utah............................ 62.46 73.72
Vermont......................... 59.01 71.31
Virgin Islands *................ 83.00 85.00
Virginia........................ 50.39 65.27
Washington...................... 50.00 65.00
West Virginia................... 74.22 81.95
Wisconsin....................... 60.68 72.48
Wyoming......................... 50.00 65.00
------------------------------------------------------------------------
* The Consolidated Appropriations Act, 2023 set the FMAP for American
Samoa, Guam, Northern Marianas, and Virgin Islands permanently at 83
percent and set the FMAP for Puerto Rico at 76 percent through Fiscal
Year 2027. For purposes of section 1118 of the Act, the percentage
used under titles I, X, XIV, and XVI will be 75 per centum for Puerto
Rico, the Virgin Islands, and Guam.
** The values for the District of Columbia (DC) in the table were set
for the state plan under titles XIX and XXI and for capitation
payments and disproportionate share hospital (DSH) allotments under
those titles. For other purposes, the percentage for DC is 50.00,
unless otherwise specified by law.
*** Nebraska received the FMAP for a disaster-recovery FMAP adjustment
State.
Table 2--Fiscal Year 2026 Disaster-Recovery Adjusted FMAP Rates
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Disaster-
FY 2026 regular Decrease in Disaster- recovery
State FY 2025 FMAP FMAP FMAP recovery adjusted FMAP
adjustment * FY 2026
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Nebraska........................................................... 57.52 54.36 3.16 1.58 55.94
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* In the first year, the Disaster-Recovery Adjustment is 50 percent of the percentage point decrease between the regular FMAP for such fiscal year and
the FMAP from the preceding fiscal year.
[[Page 94746]]
[FR Doc. 2024-27910 Filed 11-27-24; 8:45 am]
BILLING CODE 4150-15-P
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</html>Indexed from Federal Register on November 29, 2024.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.