The Paragon Health Institute has released a report outlining ways that Republican leadership can reform Medicaid program without rolling back expansion or hurting “red” states. Republicans and right-leaning policy think-tanks have long been concerned with growing program spending, but recent conversations about whether to adopt sweeping Medicaid cuts makes the appetite for this policy research particularly high. Paragon’s recommendations include: 

• Reforming the Federal Medical Assistance Percentage (FMAP) by adopting a phase down from 90% for expansion enrollees in 2026 which would decrease until it reached parity with traditional enrollees in 2034.  

• Allowing states that have expanded Medicaid to keep their expansion enrollees but reducing eligibility to households below the Federal Poverty Level.