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Medicaid and CHIP in the U.S. Territories

MACPAC executive director Anne L. Schwartz testified before the Health Subcommittee of the House Energy and Commerce Committee on the role of Medicaid and CHIP in the territories.  The testimony describes how Medicaid operates in the five U.S. territories, including program design differences between the territories and the states, and among the territories themselves.  MACPAC’s testimony also pointed out that two features of Medicaid financing – a capped federal allotment and the statutorily set federal matching rate of 55 percent – have led to chronic underfunding.  While sufficient funding is now available to cover program expenses through 2019, MACPAC estimates that all five territories will face a funding shortfall in fiscal year 2020.