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Implementing the ACA: Medicaid Spending & Enrollment Growth for FY 2014 and FY 2015

Issue Brief
  1. Bureau of Labor Statistics, The Employment Situation – September 2014. (Washington, DC: Bureau of Labor Statistics,) October 3, 2014. http://www.bls.gov/cps/.

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  2. While the share of the population over 16 participating in the labor force (labor force participation rate) did not decline over the past year, it is at a level (62.7 percent in September 2014) last seen in 1978. A portion of this decline in the labor force participation rate is due to increasing numbers of baby-boomers retiring.

    Chad Stone, Statement by Chad Stone, Chief Economist, on the August Employment Report, (Washington, DC: Center on Budget and Policy Priorities,) September 5, 2014. http://www.cbpp.org/cms/index.cfm?fa=view&id=4195.

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  3. Bureau of Labor Statistics, The Employment Situation – September 2014. (Washington, DC: Bureau of Labor Statistics,) October 3, 2014. http://www.bls.gov/cps/.

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  4. Ibid.

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  5. The first two quarters of tax revenue growth were driven by significant increases in personal income tax revenue growth; experts noted that this significant growth appeared to be artificially driven by changes in federal tax policy. While personal income tax growth slowed in the third and fourth quarters of 2013, sales tax revenue growth has remained fairly constant (over 5% each quarter) during the 2013 calendar year.

    Lucy Dadayan and Donald J. Boyd, State Tax Revenues Slip Back to Slower Growth, (Albany, NY: The Nelson A. Rockefeller Institute of Government,) March 11, 2014. http://www.rockinst.org/pdf/government_finance/state_revenue_report/2014-03-11_Data_Alertv3.pdf.

    Lucy Dadayan and Donald J. Boyd, “April Surprises” Left Many States with Bad News, (Albany, NY: The Nelson A. Rockefeller Institute of Government,) September 17, 2014.http://www.rockinst.org/pdf/government_finance/state_revenue_report/2014-09-17_Data_Alert.pdf.

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  6. Kaiser Commission on Medicaid and the Uninsured, Medicaid in a Historic Time of Transformation: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2013 and 2014, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured), October 2013. http://kff.org/medicaid/report/medicaid-in-a-historic-time-of-transformation-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2013-and-2014/.

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  7. National Health Interview Survey Early Release Program. “Health Insurance Coverage:  Early Relase of Estimates from the National Health Interview Survey, January – March 2014. Released September 16, 2014. http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201409.pdf

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  8. Kaiser Family Foundation, Measuring Changes in Insurance Coverage Under the Affordable Care Act, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured), October 2013. http://kff.org/health-reform/issue-brief/measuring-changes-in-insurance-coverage-under-the-affordable-care-act/.

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  9. Figures for expansion state spending and enrollment growth from last year’s survey included 25 states; after the survey data was collected for last year’s report, Ohio decided to move forward and implement the Medicaid expansion as of January 1, 2014. When collecting data for this year’s report, Ohio included spending and enrollment figures that reflected expanding as of January 1, 2014 and therefore were included in the expansion group.

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  10. Because the data reported here are a weighted average across all non-expansion states, the FMAP declines in larger states, such as Texas, have a larger effect on the state and total spending averages for this group.

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  11. Kaiser Family Foundation, The Role of Medicaid in State Economies and the ACA, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured), November 2013. http://kff.org/medicaid/issue-brief/the-role-of-medicaid-in-state-economies-and-the-aca/.

    Sherry Glied and Stephanie Ma, How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion. (New York City, NY: The Commonwealth Fund,) December 2013. http://www.commonwealthfund.org/Publications/Issue-Briefs/2013/Dec/Federal-Funds-Medicaid-Expansion.aspx.

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  12. National Health Interview Survey Early Release Program. “Health Insurance Coverage:  Early Release of Estimates from the National Health Interview Survey, January – March 2014. Released September 16, 2014. http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201409.pdf

    Kaiser Family Foundation, Measuring Changes in Insurance Coverage Under the Affordable Care Act, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured), October 2013. http://kff.org/health-reform/issue-brief/measuring-changes-in-insurance-coverage-under-the-affordable-care-act/.

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Methodology
  1. Kaiser Commission on Medicaid and the Uninsured, Medicaid Enrollment: June 2013 Data Snapshot, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured), January 29, 2014. http://kff.org/medicaid/issue-brief/medicaid-enrollment-june-2013-data-snapshot/.

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Appendix
  1. State Health Facts, Federal Medical Assistance percentage (FMAP) for Medicaid and Multiplier, (Washington, DC: Kaiser Family Foundation,) downloaded March 2014. http://kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/.

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  2. Kaiser Commission on Medicaid and the Uninsured estimates based on the NASBO’s November 2013 State Expenditure Report (data for Actual FY 2012.)

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