When is Medicaid financing "money laundering" and when is it "creative financing"? The Trump administration just finalized rules that will cut $900 billion from Medicaid over the next decade—closing the "B1/B2 test loophole” and slashing State Directed Payments. In this episode, the AMGA Public Policy team unpacks two massive rule changes that are about to upend how states fund Medicaid: new restrictions on provider taxes and dramatic cuts to State Directed Payments. We're talking about these cutsaffecting everything from rural hospital survival to medical education funding. By the end, you'll understand why this isn't just about Medicaid, but about whether we're inadvertently dismantling the financial foundation of American healthcare, one policy change at a time.