This chart book explores utilization and expenditures for Medicaid-funded LTSS in Maryland for state fiscal year (FY) 2019 through FY 2023. The focus of this chart book is on Medicaid nursing facility services, with one chapter that illustrates Maryland’s efforts at providing home and community-based services (HCBS) to an increasing number of Medicaid recipients who may otherwise be served in nursing facilities.
The Hilltop Institute has released updated analysis of the Medicaid provider tax provisions of the Senate budget reconciliation bill. The estimates, which model the version of the bill released from the Senate Finance committee on June 16, 2025, update Hilltop’s earlier analysis of provider taxes. Authored by Hilltop Director of Analytics & Research Dr. Morgan Henderson, Senior Data Scientist Dr. Leigh Goetschius, and Executive Director Alice Middleton, this analysis uses hospital provider tax rates and net patient revenue data to calculate the estimated state-level impacts of the proposed Senate legislation. The authors find that, once the provider tax reductions are fully implemented as of 2031, this legislation would reduce federal funding to 18 Medicaid expansion states by over $11.9 billion annually. Moreover, the impact will not be uniform: the impact will be largest in states with high hospital provider tax rates. Specifically, the authors find that Arizona, New Hampshire, Nevada, Iowa, Vermont, and Michigan would each at lose least 7.5% of their federal Medicaid funding as a result of this bill.
While the proposed legislation proposes a suite of Medicaid policy changes that would interact in various ways, this analysis only considers the hospital provider tax change in isolation. This is the latest in a series of Hilltop analyses focused on modeling state-level impacts of potential federal Medicaid policy changes.
Principal Policy Analyst Christine Gill, PhD, presented this poster at the 2025 AcademyHealth Annual Research Meeting (ARM) held June 7–9 in Minneapolis.
This document, written by Hilltop Director of Analytics & Research Morgan Henderson, Senior Data Scientist Leigh Goetschius, and Interim Executive Director Alice Middleton, quantifies the impact of removing the 6% provider tax safe harbor threshold on state-level federal Medicaid funding. Using data on hospital and nursing facility tax rates and net patient revenue, this analysis finds that eliminating the 6% provider tax threshold for hospitals and nursing facilities would put $83.7 billion of federal Medicaid funding at risk.
The Model Waiver provides services to individuals with medically complex needs and a chronic hospital or nursing facility level of care to be supported in their own homes or community-based settings. This infographic presents information for fiscal year (FY) 2019 through FY 2023.
The Medical Day Care Services (MDC) Waiver provides health, social, and related support services in a community-based setting to functionally disabled adults age 16 and older. This infographic presents information for fiscal year (FY) 2019 through FY 2023.
The Family Supports Waiver (FSW) provides community-based services and supports to individuals aged 21 years or younger with developmental or intellectual disabilities. This infographic presents information for fiscal year (FY) 2019 through FY 2023.
The Community Personal Assistance Services (CPAS) program is a state plan program that provides in-home personal assistance services, nurse monitoring, and supports planning to older adults and individuals who need assistance with at least one activity of daily living. This infographic presents information for fiscal year (FY) 2019 through FY 2023.
The Community Pathways Waiver (CPW) provides community-based services and supports to individuals with developmental or intellectual disabilities. The waiver includes both self-directed and traditional service delivery models. This infographic presents information for fiscal year (FY) 2019 through FY 2023.
The Home and Community-Based Options Waiver (CO Waiver) provides community-based services and supports that enable older adults and those with physical disabilities to continue living in their own homes or in assisted living facilities. This infographic presents information for fiscal year (FY) 2019 through FY 2023.