NACo offers new Medicaid resources as Congress advances Budget Resolutions with major Medicaid reform implications

Key Takeaways

On April 10, the U.S. House of Representatives voted to adopt a Senate-passed budget resolution, marking the next step in the budget reconciliation process. While this procedural move advances a shared framework, the House and Senate still have drastically different federal spending priorities, which has led to different benchmarks for each chamber in the shared resolution.

• The House must find at least $1.5 trillion in savings to the federal budget over ten years, likely targeting major federal spending programs, such as Medicaid. In a previous House budget resolution, the Energy & Commerce Committee was instructed to identify $880 billion in savings—which could shift program costs onto county governments.
• The Senate set a much lower federal savings threshold—$5 billion—but notably defines this amount as a floor, not a ceiling. Lawmakers are widely expected to go beyond this baseline, potentially aligning more closely with the House’s increased savings.

These proposals represent significant potential cost shifts to counties, particularly in the area of Medicaid financing. To help county leaders understand what’s at stake, NACo has developed two new resources:

1. New Medicaid One-Pager 
   This one pager reviews key financing reform proposals and their fiscal impact on counties.
2. Upcoming Webinar Series: Federal Reforms to Medicaid Financing: What Counties Should Know 
   This two-part series will take place next month and offer essential insights for county officials on potential policy changes related to Medicaid reform and strategies to navigate them.
   o    Register for Part 1 on May 6 at 3 p.m. – 4 p.m. ET
   o    Register for Part 2 on May 12 at 3 p.m. – 4 p.m. ET

To learn more about Medicaid financing reforms, please visit our online Medicaid hub.