What's at Stake in Federal-State Fiscal Relations
The 115th Congress convened earlier this month with an ambitious agenda that could upend the status quo in federal-state fiscal relations. Among the possibilities:
- Repeal or replacement of the Affordable Care Act (ACA) would have a significant impact on health programs generally, and Medicaid specifically.
Federal tax reform could affect states through specific policies, or through state linkages to the federal tax code.
Other significant changes to mandatory programs have been proposed in recent years, including converting Medicaid and the Supplemental Nutrition Assistance Program (SNAP) to block grants.
Completion of the fiscal year (FY) 2017 budget process might bring changes in discretionary programs, as may appropriations in FY 2018 and ensuing years.
Reinstatement of the federal debt limit later this year will provide an opening for significant policy changes. In the past, the debt limit debate has been associated with budgetary, economic, and policy upheaval.
Certain regulations may be targeted for reform or elimination, with various tools available to pursue such actions.