This issue brief provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2019 (July 1, 2018 through June 30, 2019 in most states). Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider. In total, we reviewed 39 proposed state budgets and text from 46 state of the state speeches. This review revealed that while state revenue collections improved in 2017 compared to 2016, considerable economic and regional variation persists, many states are facing significant budget challenges unrelated to Medicaid such as unfunded pension liabilities or falling oil prices, and the outlook for 2018 remains uncertain due, in part, to the impacts of the 2017 Federal Tax Reform Act.
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Medicaid provides health insurance coverage for about one in five Americans and is the largest payer for long-term care services in the community and nursing homes. Efforts in 2017 to repeal and replace the Affordable Care Act (ACA) and cap federal financing for Medicaid were unsuccessful but help to set the stage for 2018. As 2018 begins, there is a focus on administrative actions using Medicaid Section 1115 demonstration waivers, state actions on Medicaid expansion, and funding for the Children’s Health Insurance Program (CHIP) and other federal health care priorities. Medicaid in 2018 is also likely to continue to be part of both federal and state budget deliberations. Pressures to control the federal deficit may reignite efforts to reduce or cap federal Medicaid spending. In addition, Governors will soon release proposed budgets for state FY 2019 that will need to account for uncertainty around CHIP and Medicaid, changes in the economy and the effects of the recent tax legislation as well as funding for rising prescription drugs and initiatives to combat the opioid epidemic. This brief examines these issues.
Federal funding for the Children’s Health Insurance Program (CHIP) expired on September 30, 2017. CHIP covers 8.9 million children in working families who earn too much to qualify for Medicaid but cannot afford or access private coverage. (See here for state Medicaid and CHIP eligibility limits for children.) This fact…
50-State Survey Finds Medicaid Enrollment Growth Slowing, with an Uptick in Spending Growth Driven by Provider Rate Increases and Rising Costs for Rx Drugs and Long-Term Care
Medicaid enrollment growth slowed to 2.7 percent in state fiscal year 2017, down from 3.9 percent the prior year and far off the peak of 13.2 percent in 2015 that followed implementation of the Affordable Care Act’s (ACA) Medicaid expansion, according to a new survey from the Kaiser Family Foundation.…
Medicaid in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018 at a Forum with the National Association of Medicaid Directors
At 9:30 a.m. ET on Thursday, Oct. 19, the Kaiser Family Foundation released its 17th annual 50-state Medicaid budget survey for state fiscal years 2017 and 2018. Kaiser and the National Association of Medicaid Directors (NAMD) are holding a joint briefing to discuss trends in enrollment and spending and highlight…
This page provides access to the reports stemming from the 50-state Medicaid budget surveys published annually since 2000 by the Kaiser Family Foundation (KFF). It tracks trends in Medicaid spending and enrollment, as well as Medicaid policy actions around eligibility and enrollment, provider rates, provider taxes/fees, premiums and cost-sharing, benefits and pharmacy, long-term care and delivery system and payment reform.
This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2017 and 2018. Findings are based on interviews and data provided by state Medicaid directors as part of the 17th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) survey and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.
Health Affairs Blog: Can States Substantially Reduce Medicaid Spending Through Delivery System And Financing Reform?
In a Health Affairs blog post, Joshua M. Wiener and Melissa Romaire of RTI International and MaryBeth Musumeci of the Kaiser Family Foundation examine whether states could successfully cope with substantial reductions in federal Medicaid funding under a per capita cap or block grant system by improving efficiency in the…
Better Care Reconciliation Act (BCRA): State-by-State Estimates of Reductions in Federal Medicaid Funding
This brief provides national and state-by-state estimates of the reductions in federal spending under the Better Care Reconciliation Act for the period 2020-2029 and for 2029 in order to see the full effect of policy changes over a ten-year period.
State-by-State Estimates of Reductions in Federal Medicaid Funding Under Repeal of the ACA Medicaid Expansion
Congressional debate around the Affordable Care Act (ACA) has recently included a proposal to repeal the ACA, including the provision allowing states to extend Medicaid to childless adults up to 138% FPL and providing enhanced federal funds for the Medicaid expansion. This brief provides estimates of changes in federal Medicaid funds and Medicaid coverage for adults covered through the ACA expansion if the expansion is eliminated starting in 2020. A repeal of the Medicaid expansion would have significant coverage and financing implications for the 31 states and the District of Columbia that have implemented the expansion.