OKPOLICY.ORG
FMAP (Federal Medical Assistance Percentage) is the share of Medicaid expenditures paid by the federal government.
Medicaid is funded through a combination of federal and state dollars. The standard federal share is determined by a mathematical formula, laid out in federal statute, that considers a state’s per capita income in relation to national per capita income. States with higher personal income receive a lower federal match (but never less than 50 percent), while states with lower personal income get a higher federal match (but never more than 82 percent).
Under the law, the federal share is recalculated annually based on the most-recently available three-year data on personal income. States that are enjoying stronger economic growth than the national average will see their federal match decline, and vice versa. On several occasions, Congress has increased the FMAP for all states during recessions, most recently boosting the FMAP for all states by 6.2 percentage points effective January 1, 2020 in response to COVID-19. The enhanced COVID match rate began to phase down as of April 1, 2023 and expired January 1, 2024.
Oklahoma’s FMAP for federal fiscal year 2024 is 67.04 percent, a decrease from its fiscal year 2024 FMAP of 67.53 percent. Mississippi currently has the highest FMAP (excluding U.S. territories) at 76.90 percent, while ten states have a 50.0 percent FMAP. In years when a state’s FMAP rate fluctuates by a substantial amount, it can have a significant impact on the state budget.
Along with the standard FMAP, some Medicaid populations and services are eligible for an enhanced FMAP. The federal share is 100 percent for Medicaid-eligible Native Americans and Alaska Natives through Indian Health Service (IHS) and tribal facilities. It is 90 percent for adults with incomes up to 138 percent of the federal poverty level made eligible by the Affordable Care Act, as well as for family planning services and certain other services. Certain low-income children and pregnant women are also eligible for an enhanced state-specific FMAP through the State Children’s Health Insurance Program (S-CHIP).
