Medicaid Improvement and State Flexibility Act of 2025

This bill allows states to create new Medicaid demonstration projects that give enrollees an electronic benefits card for primary care and medications, with unused funds converted to cash annually. Participants could also enroll in state-determined catastrophic insurance for coverage beyond the card's limits. The projects must not increase federal spending compared to standard Medicaid and prohibit abortion coverage except when necessary to save a mother's life or in cases of rape or incest. It directly affects Medicaid enrollees in states that adopt such projects, granting states more flexibility in program design.