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Utah's Medicaid expansion currently covers low-income adults up to 133% of the federal poverty level, and this bill revises what happens if the federal government reduces its funding match for that population below 90%. Under current law, expansion would end the following July 1 after such a cut; this bill instead ends the state's authority to run expansion the day after the Legislature adjourns from the next general session following the funding reduction, giving lawmakers a window to respond, and requires the department to begin winding down the program once that authority sunsets. The bill also requires the department to proactively end any other state program that would trigger a reduction in federal matching funds for expansion, and to submit a cost-containment proposal within 60 days of learning that funding will be cut, outlining options such as freezing administrative hiring, suspending or reversing provider rate increases, eliminating optional benefits, or closing enrollment to new members. Additionally, the bill adjusts eligibility rules for the state's targeted adult Medicaid program, allowing certain enrollees to keep coverage for up to a 12-month certification period only if federal approval is obtained, and adds new reporting requirements on how leftover Medicaid ACA Fund money should be used if expansion authority ends.