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.
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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.
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 will release its 17th annual 50-state Medicaid budget survey for state fiscal years 2017 and 2018. Kaiser and the National Association of Medicaid Directors (NAMD) will hold a joint briefing to discuss trends in enrollment and spending and…
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.
Under a per capita cap, per enrollee spending would be capped, but the total amount of federal dollars to states could vary with enrollment changes and states would not be able to impose enrollment caps. Faced with restrictions in federal financing, states would have to make hard choices. This brief outlines the key measures states could use to manage their budgets and the associated challenges under a per capita cap: raise taxes or make other cuts, reduce benefits, limit coverage of high cost enrollees, reduce rates or implement delivery system reforms, and promote personal responsibility. Each option has challenges that are identified in the brief.
This issue brief considers the feasibility of realizing substantial Medicaid cost savings through strategies aimed at improving delivery system and administrative efficiency. We review the literature about the potential for Medicaid cost savings from four strategies related to acute care services: (1) premiums, cost-sharing, and enrollee wellness incentives, (2) complex care management, (3) patient-centered medical homes, and (4) alternative payment models, and another four strategies related to long-term services and supports: (5) tightening financial eligibility rules for long-term care services, (6) promoting private long-term care insurance, (7) expanding home and community-based services (HCBS), and (8) increasing use of managed long-term services and supports.
As Congress presses forward with efforts to repeal and replace the Affordable Care Act, a new interactive map from the Kaiser Family Foundation provides a window into the changes in health insurance coverage and financing in each state under the 7-year-old law. The ACA increased enrollment in health insurance by…
Factors Affecting States’ Ability to Respond to Federal Medicaid Cuts and Caps: Which States Are Most At Risk?
This issue brief examines the factors that could affect states’ ability to cope with reductions in federal Medicaid funding of the sort proposed in the House-passed American Health Care Act (AHCA), which would eliminate enhanced federal matching funds for the Affordable Care Act’s Medicaid expansion and convert Medicaid to a per capita cap or block grant system of financing.