Final answer:
State manipulation of the Medicaid requirement has impacted the balance of cost-sharing, raising the federal share above the formula-specified level, but the exact percentage points are not provided.
Step-by-step explanation:
The question pertains to the federal share of Medicaid costs and by how much state manipulation of the Medicaid match requirement has raised this federal share above what the formula initially specified. While the specific percentage points are not provided in the reference materials supplied, it is clear that state-level decisions, such as those related to setting income thresholds for qualification and elective expansion under the ACA, significantly impact the cost distribution between state and federal governments. Total costs for Medicaid in 2020 were about $627 billion, with approximately $405 billion covered by the federal government. This suggests that state policies and federal incentives have considerable effects on the Medicaid program's fiscal dynamic and the balance of cost-sharing between the state and federal levels.