The federal government’s share of each state’s Medicaid bill resets today. The Federal Medical Assistance Percentages for fiscal year 2027, which cover October 1, 2026 through September 30, 2027, put ten states at the statutory floor of 50.00 percent. At the other end of the 50 states, Mississippi draws 77.32 percent.
The rates decide how many cents of every Medicaid dollar Washington pays and how many a state must find on its own. For older Americans on Medicaid, the split shapes how much money each state has to work with for the coverage it offers.
The ten states at the floor
The table in the Department of Health and Human Services notice, published in the Federal Register as 90 FR 54696, lists exactly ten states at 50.00 percent: California, Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Washington and Wyoming.
At that rate, a state and the federal government split each eligible Medicaid dollar evenly. The notice carries the signature of HHS Secretary Robert F. Kennedy Jr., and the department lists Amelia Whitman of the Office of Health Policy in the Office of the Assistant Secretary for Planning and Evaluation as the contact for questions.
The same table shows how tightly several other states cluster just above the floor. Virginia is at 50.02 percent and South Dakota at 50.56 percent. Minnesota sits at 51.36 percent and Alaska at 51.37 percent. Illinois and North Dakota are both at 52.91 percent. A shift of a fraction of a point at that level moves a state’s federal share by a small amount per dollar, but across a program of Medicaid’s size the totals add up.
Why 50 percent is the floor
The floor is written into law rather than chosen by the department. The notice quotes the statutory language directly: the Federal medical assistance percentage “shall in no case be less than 50 per centum or more than 83 per centum.” A state whose formula result would fall below 50 percent is simply held at 50.00. Ten states land there for fiscal 2027.
The 83 percent ceiling applies to the territories rather than the states. American Samoa, Guam, the Northern Mariana Islands and the Virgin Islands are each listed at 83.00 percent, while Puerto Rico is listed at 76.00 percent and the District of Columbia at 70.00 percent.
Mississippi at the top of the state list
Mississippi’s 77.32 percent is the highest figure for any of the 50 states in the notice. Put in plain terms, the federal government pays about 77 cents of each eligible Medicaid dollar in Mississippi and the state covers the remaining 22.68 cents. In California or New York, the state covers 50 cents.
West Virginia follows at 74.25 percent and Alabama at 72.55 percent. Kentucky is listed at 71.56 percent and New Mexico at 71.47 percent. Arkansas, at 70.52 percent, is the next state past the 70 mark.
A separate rate for children’s coverage
The notice also publishes enhanced rates, known as eFMAP, in the second column of its first table. In the department’s words, these rates are used in the Children’s Health Insurance Program and in Medicaid for expenditures on medical assistance provided to certain children. They are higher than the standard figure in most states. Alabama, for example, is listed at 80.79 percent on that measure against 72.55 percent for the standard rate.
What the rates sit beside this year
The new rates arrive while Medicaid rules are changing elsewhere. A CMS fact sheet on its community engagement interim final rule, issued June 1, 2026, says states must implement a work-and-activity requirement by January 1, 2027, for non-pregnant adults aged 19 through 64 who are not enrolled in Medicare. The agency says 43 states and the District of Columbia are affected, and that the requirement does not reach adults over 64.
Exemptions listed by CMS include people who are disabled or medically frail, parents and caretakers of children under 14, American Indians and Alaska Natives, veterans with total disability ratings and former foster youth. Readers who are 65 or older are outside the requirement, though family members in the 19-to-64 range may not be.
What the figures do and do not settle
The percentages fix only the federal share of eligible spending. They do not set who qualifies for Medicaid, which services a state covers or how much a state spends. Those choices remain with each state’s program, which is why help with Medicare premiums and cost-sharing differs from one state to the next even where the federal share is identical.
The Federal Register notice remains the controlling record for the rates. Its table gives each state’s figure to two decimal places for the full year, and any reader trying to understand a state’s funding picture can find that state’s row there, along with the eFMAP column, before looking at anything a state budget office says about the same program.
Medicare cost help is set state by state
Medicare beneficiaries on tight budgets often have to work out which cost-help options their own state runs, since programs and rules vary by state. The Medicare Cost & Coverage Protection Kit is a paid guide for people in that position who want the state-level information in one place.
The Medicare Cost & Coverage Protection Kit is a 10-page kit that includes 51 state Medicare cost-help packs, the prior-authorization appeal steps and a medication and cost tracker.
Open the Medicare Cost & Coverage Protection Kit and its 51 state cost-help packs →
This article was produced with AI assistance and checked against the primary sources linked above.
Warren Cohen is a finance writer based in Phoenix, Arizona, covering personal finance topics including credit, banking, and beginner investing. He earned his degree in business administration from Arizona State University and began his career working in consumer finance, where he gained direct experience with lending and credit systems. He now writes for personal finance websites and fintech platforms, focusing on clear, practical content that helps readers make informed financial decisions.
