FY 2023 FMAP Projections: A Moving Target

The U.S. Census Bureau released the first results of the 2020 decennial census—actual state resident population totals for April 2020 (see FFIS Issue Brief 21-05). While population shifts will affect states’ share of funding in many grant programs, the biggest impact will be felt in Medicaid. The new population data will be used to calculate the fiscal year (FY) 2023 Federal Medical Assistance Percentages (FMAPs), which are based on per capita personal incomes for calendar years (CYs) 2018-2020. The FY 2023 FMAPs will also reflect the effects of federal COVID-19 pandemic response programs on state personal income.  

This brief provides FY 2023 FMAP and enhanced FMAP projections based on the new population data and preliminary state personal income data for 2020 released by the Bureau of Economic Analysis (BEA) in late March. The final FMAPs will use revised BEA per capita personal income data released in September. In a normal year, the BEA revisions can have a large impact on final FMAPs. This year’s projections are even less certain with the combination of significant COVID relief and ambiguities over the release of additional census data resulting from the slow processing of results. That said, FFIS projects that FMAPs will increase in 21 states and decline in 18 states, ranging from a +1.13 percentage-point change in Hawaii to a -0.95 percentage-point change in Arizona.