Federalism · Assumption Ledger
The Federal Assumption Ledger
A per-state public record: what Washington assumed, what the state kept, and what the state did with it. Daylight, not mandate.
ILLUSTRATIVE — projected from FY-baseline. Updated annually from NASBO state expenditure reports and state ACFRs once enacted; this is a proposal, not retrospective accounting.
When Distributed Healthcare absorbs the federal Medicaid population, each state keeps its own Medicaid contribution — unconditioned. States may cut taxes with it, fund other priorities, or augment local delivery. The ledger puts each choice on the record: no federal authority over state rates exists or is claimed; the instrument is publicity.
| State | Freed state share ($B/yr, projected) | What the state did with it |
|---|---|---|
| California | $29.1B | Reported at absorption (descriptive budget-category shifts only) |
| Texas | $22.8B | Reported at absorption (descriptive budget-category shifts only) |
| Florida | $16.9B | Reported at absorption (descriptive budget-category shifts only) |
| New York | $14.6B | Reported at absorption (descriptive budget-category shifts only) |
| Pennsylvania | $9.7B | Reported at absorption (descriptive budget-category shifts only) |
| Illinois | $9.3B | Reported at absorption (descriptive budget-category shifts only) |
| Ohio | $8.8B | Reported at absorption (descriptive budget-category shifts only) |
| Georgia | $8.2B | Reported at absorption (descriptive budget-category shifts only) |
| North Carolina | $8.1B | Reported at absorption (descriptive budget-category shifts only) |
| Michigan | $7.5B | Reported at absorption (descriptive budget-category shifts only) |
| New Jersey | $6.9B | Reported at absorption (descriptive budget-category shifts only) |
| Virginia | $6.5B | Reported at absorption (descriptive budget-category shifts only) |
| Washington | $5.8B | Reported at absorption (descriptive budget-category shifts only) |
| Arizona | $5.5B | Reported at absorption (descriptive budget-category shifts only) |
| Tennessee | $5.3B | Reported at absorption (descriptive budget-category shifts only) |
| Massachusetts | $5.2B | Reported at absorption (descriptive budget-category shifts only) |
| Indiana | $5.2B | Reported at absorption (descriptive budget-category shifts only) |
| Missouri | $4.6B | Reported at absorption (descriptive budget-category shifts only) |
| Maryland | $4.6B | Reported at absorption (descriptive budget-category shifts only) |
| Wisconsin | $4.4B | Reported at absorption (descriptive budget-category shifts only) |
| Colorado | $4.4B | Reported at absorption (descriptive budget-category shifts only) |
| Minnesota | $4.3B | Reported at absorption (descriptive budget-category shifts only) |
| South Carolina | $4.0B | Reported at absorption (descriptive budget-category shifts only) |
| Alabama | $3.8B | Reported at absorption (descriptive budget-category shifts only) |
| Louisiana | $3.4B | Reported at absorption (descriptive budget-category shifts only) |
| Kentucky | $3.4B | Reported at absorption (descriptive budget-category shifts only) |
| Oregon | $3.1B | Reported at absorption (descriptive budget-category shifts only) |
| Oklahoma | $3.1B | Reported at absorption (descriptive budget-category shifts only) |
| Connecticut | $2.7B | Reported at absorption (descriptive budget-category shifts only) |
| Utah | $2.5B | Reported at absorption (descriptive budget-category shifts only) |
| Iowa | $2.4B | Reported at absorption (descriptive budget-category shifts only) |
| Nevada | $2.4B | Reported at absorption (descriptive budget-category shifts only) |
| Arkansas | $2.3B | Reported at absorption (descriptive budget-category shifts only) |
| Mississippi | $2.2B | Reported at absorption (descriptive budget-category shifts only) |
| Kansas | $2.2B | Reported at absorption (descriptive budget-category shifts only) |
| New Mexico | $1.6B | Reported at absorption (descriptive budget-category shifts only) |
| Nebraska | $1.5B | Reported at absorption (descriptive budget-category shifts only) |
| Idaho | $1.5B | Reported at absorption (descriptive budget-category shifts only) |
| West Virginia | $1.3B | Reported at absorption (descriptive budget-category shifts only) |
| Hawaii | $1.0B | Reported at absorption (descriptive budget-category shifts only) |
| New Hampshire | $1.0B | Reported at absorption (descriptive budget-category shifts only) |
| Maine | $1.0B | Reported at absorption (descriptive budget-category shifts only) |
| Montana | $0.8B | Reported at absorption (descriptive budget-category shifts only) |
| Rhode Island | $0.8B | Reported at absorption (descriptive budget-category shifts only) |
| Delaware | $0.7B | Reported at absorption (descriptive budget-category shifts only) |
| South Dakota | $0.7B | Reported at absorption (descriptive budget-category shifts only) |
| North Dakota | $0.6B | Reported at absorption (descriptive budget-category shifts only) |
| Alaska | $0.5B | Reported at absorption (descriptive budget-category shifts only) |
| District of Columbia | $0.5B | Reported at absorption (descriptive budget-category shifts only) |
| Vermont | $0.4B | Reported at absorption (descriptive budget-category shifts only) |
| Wyoming | $0.4B | Reported at absorption (descriptive budget-category shifts only) |
Per-state values are population-scaled placeholders against a ~$250B/yr national state-share total — kept illustrative by design until enactment reporting begins (NASBO / state ACFRs are the post-enactment sources). The final column is descriptive only — budget-category shifts, never a judgment. Columns for later federal assumptions attach to the same rows.