OBBBA Impacts: Medicaid Cuts & State Tax Implications

This PYA Summer CPE Symposium session reviews Medicaid and state tax implications discussed in connection with the One Big Beautiful Bill Act. Ramzi Fadayel discusses Medicaid provider taxes, state-directed payments, community engagement requirements, Medicare DSH, 340B Drug Pricing Program eligibility, retroactive coverage, cost sharing, erroneous Medicaid payments, and related Medicaid provisions. Patrick Birmingham discusses potential state tax responses to budget pressure, including wealth and high-earner taxes, spending measures, reserve funds, decoupling from federal tax provisions, and selected state case studies. This discussion is intended for healthcare finance, reimbursement, tax, compliance, legal, and executive leaders evaluating Medicaid and state tax policy implications. What Viewers Will Learn • How Medicaid financing and FMAP affect state and provider exposure • How provider tax changes may affect Medicaid funding structures • How state-directed payment limits may affect provider reimbursement • How community engagement requirements may affect Medicaid volume • How Medicare DSH and 340B eligibility could be affected • How states may respond through tax and budget strategies • What legal, economic, and business considerations may arise from higher state taxes