H.R. 3154 — Medicaid Improvement for Insular Areas Act of 2025

This section eliminates the Medicaid funding limitations under subsections (f) and (g) of Section 1108 for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa beginning with FY2025 (previously applicable through FY2024). (As background, those subsections cap total annual federal Medicaid payments to territories at fixed "ceiling amounts," such as $107,255,000 for Puerto Rico, regardless of actual expenditures; thus, affected territories will receive uncapped federal matching funds for Medicaid based on their applicable federal medical assistance percentages.) It also makes conforming amendments to Sections 1902(j) and 1903(u) by striking references to the Section 1108(f) limitation.