Health Affairs October 16, 2025
Editor’s Note:
This article is part of a Health Affairs Forefront featured topic, Medicaid Financing. The featured topic includes analysis, proposals, and commentary that will inform policies on the state and federal levels to address sustainability, efficiency, and access to care in Medicaid programs. Submissions will be reviewed on a rolling basis until the deadline. Health Affairs Forefront alone reviews all submissions then selects, edits, and publishes them only if they meet Forefront’s editorial standards. We are grateful to Arnold Ventures for supporting this work.
Medicaid is built upon a contradiction: a federal program to provide healthcare benefits for the poorest Americans is financed through a system of grants that go disproportionately to the wealthiest states.
This is because there...
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