President Donald Trump’s administration has moved to shut down a long‑running Medicaid financing loophole that officials say allowed states to shift billions in costs onto federal taxpayers. For more than a decade, some states used specialized health care‑related tax structures that effectively pushed their share of Medicaid financing to the federal government, CMS says. Among the major provisions:Bans higher tax rates on Medicaid business than on non‑Medicaid business , cutting off the core mechanism behind the loophole. Blocks indirect or disguised tax structures that served as back‑door pathways for generating excessive federal matching funds. "With this rule, CMS is ending these inappropriate schemes and ensuring every federal Medicaid dollar is used as Congress intended."