The financing of state Medicaid programs is a substantial topic for every state’s budget and appropriations committees, with decisions that affect coverage, quality and state-based change. Medicaid typically makes up 15 percent to 20 percent of state budgets. Legislators also seek to earmark funds for programs, and leverage federal dollars to support existing programs and new projects. The Affordable Care Act brings additional options and requirements. Read reports on federal matching funds (FMAP), state-initiated health provider fees, and ways that states make budget decisions on health.