I 
119TH CONGRESS 
1ST SESSION H. R. 3321 
To amend title XIX of the Social Security Act to phase out the enhanced 
Federal match applicable to medical assistance provided to low-income adults. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 9, 2025 
Mr. ROY (for himself, Mr. FITZGERALD, Mr. GILL of Texas, Mr. OGLES, Mrs. 
SPARTZ, Mr. DONALDS, Mr. CLOUD, Mr. HARRIS of Maryland, Ms. 
BOEBERT, Mr. SELF, Mr. HIGGINS of Louisiana, Mr. BRECHEEN, Mr. 
PERRY, Mr. GOSAR, Mr. TIFFANY, and Mr. BIGGS of Arizona) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce 
A BILL 
To amend title XIX of the Social Security Act to phase 
out the enhanced Federal match applicable to medical 
assistance provided to low-income adults. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ending Medicaid Dis-
crimination Against the Most Vulnerable Act’’. 
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SEC. 2. PHASE-OUT OF ENHANCED FEDERAL MATCH FOR 
MEDICAL ASSISTANCE PROVIDED TO LOW-IN-
COME INDIVIDUALS UNDER MEDICAID. 
(a) IN GENERAL.—Section 1905(y) of the Social Se-
curity Act (42 U.S.C. 1396d(y)) is amended— 
(1) in paragraph (1)— 
(A) in subparagraph (A), by inserting 
‘‘and subject to paragraph (4)’’ after ‘‘Notwith-
standing subsection (b)’’; 
(B) in subparagraph (D), by striking ‘‘; 
and’’ and inserting a semicolon; 
(C) in subparagraph (E), by striking ‘‘and 
each year thereafter.’’ and inserting ‘‘through 
2026;’’; and 
(D) by adding at the end the following new 
subparagraphs: 
‘‘(F) for calendar quarters in each of cal-
endar years 2027 through 2034, the percentage 
that applied under this subsection for calendar 
quarters in the preceding calendar year minus 
the applicable number of percentage points de-
termined for the State under paragraph (3) or, 
if higher, the Federal medical assistance per-
centage otherwise determined for the State and 
year under subsection (b) (without regard to 
this subsection); and 
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‘‘(G) for calendar quarters in 2035 and 
each year thereafter, the Federal medical assist-
ance percentage otherwise determined for the 
State and year under subsection (b) (without 
regard to this subsection).’’; and 
(2) by adding at the end the following new 
paragraphs: 
‘‘(3) APPLICABLE
NUMBER
OF
PERCENTAGE 
POINTS.—For purposes of paragraph (1)(F), the ap-
plicable number of percentage points for a State is 
the number of percentage points equal to— 
‘‘(A) the percentage points difference be-
tween— 
‘‘(i) 90 percent; and 
‘‘(ii) the Federal medical assistance 
percentage determined for the State under 
subsection (b) (without regard to this sub-
section) for fiscal year 2026; divided by 
‘‘(B) 8. 
‘‘(4) RULES OF APPLICATION FOR CALENDAR 
YEARS AFTER 2024.— 
‘‘(A) IN GENERAL.—Notwithstanding any 
other provision of law, for calendar years after 
2024— 
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‘‘(i) paragraph (1) shall not apply to 
a non-expansion State (as defined in sub-
paragraph (B)); 
‘‘(ii) if a non-expansion State elects 
on or after the date of enactment of this 
paragraph to expend amounts for all or 
any 
individuals 
described 
in 
section 
1902(a)(10)(A)(i)(VIII), the Federal med-
ical assistance percentage otherwise deter-
mined for the State and year under sub-
section (b) (without regard to this sub-
section) shall apply to amounts expended 
by such State for medical assistance for 
such individuals; and 
‘‘(iii) an expansion State (as defined 
in such subparagraph) may, at the option 
of the State, elect to only expend amounts 
for medical assistance for newly eligible in-
dividuals 
described 
in 
section 
1902(a)(10)(A)(i)(VIII) whose income does 
not exceed 100 percent of the Federal pov-
erty line (as defined for purposes of such 
section) and continue to receive the Fed-
eral medical assistance percentage specified 
under paragraph (1) for such amounts. 
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