Select States’ Use of Health Care-Related Taxes as the State Share of Medicaid Expenditures

OBJECTIVE

States increasingly use health care-related taxes instead of State general funds to finance their share of Medicaid expenditures.  Health care-related taxes allow States to grow their Medicaid programs without increasing their general fund contribution.  Federal Medicaid coverage is generally limited to U.S. citizens, U.S. nationals, and qualified noncitizens.  Individuals without satisfactory immigration status are not eligible for full-scope Federal Medicaid benefits, but they are eligible for emergency services funded under Medicaid.  States may elect to provide health care coverage beyond emergency services (i.e., additional health care coverage) for individuals who do not qualify for Medicaid, including undocumented immigrants, using State-only funds.  Our data brief will provide information about selected States’ use of Federal Medicaid reimbursement obtained through health care-related taxes.  It will also identify State-funded health care programs that provide services, in addition to emergency services under Medicaid, to individuals who do not meet Medicaid eligibility requirements.

TIMELINE

• February 17, 2026
  Announced
• Today
  Office of Audit Services In-Progress
• Est FY2028
  Estimated Fiscal Year for Project Completion

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