NewsNTech
Medicaid and CHIP route federal dollars through a shared funding structure that gives states broad coverage authority, subject to federal contribution rules.
The Trump administration has applied those rules to exclude gender-affirming care for children: federal funds in both programs will no longer cover those treatments. States retain the option to cover the care themselves.
How the funding structure creates the stakes Medicaid and CHIP operate as federal-state programs.
Washington sets the rules for what federal dollars can reimburse; states administer plans and set their own covered service lists.
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