State Budgets

States expect national Medicaid enrollment to decline by about 4% and state Medicaid spending to rise by 7% in fiscal year (FY) 2025. These rates follow a larger but anticipated enrollment decline and state spending increase in FY 2024, as pandemic-era policies and federal funding expired, according to KFF’s 24th…

Under estate recovery, state Medicaid programs are required to recover the costs of long-term care and related hospital and prescription drug services for enrollees ages 55 and older. KFF examines the wide variation in estate recovery practices across states as well as the criticisms of this policy, which have led to federal proposals to modify or reduce it.

KFF President and CEO Drew Altman examines the coming squeeze on state budgets and state Medicaid programs, stemming from declining federal matching funds, weakening state revenues, and competing state priorities, and the challenges it poses for states seeking to strengthen their programs and try innovative new approaches.

State legislatures are currently gathering to develop new budgets for state fiscal year (FY) 2025. Heading into this budget cycle, state fiscal conditions are shifting, with state revenues starting to decline following steep revenue growth during the pandemic. This issue brief examines trends in state fiscal conditions and discusses how state budgets and macroeconomic conditions may affect individuals and state Medicaid programs.

In this column, KFF President and CEO Drew Altman explores the nation’s twin health cost crises of affordability, especially for people who are sick and need a lot of health care, and national health spending, and why the solutions often work at cross purposes.

This issue brief analyzes Medicaid enrollment and spending trends for FY 2023 and FY 2024, based on data provided by state Medicaid directors as part of the 23rd annual survey of Medicaid directors in states and the District of Columbia.

This report highlights certain policies in place in state Medicaid programs in FY 2023 and policy changes implemented or planned for FY 2024, which began on July 1, 2023 for most states.

The 23rd annual survey of state Medicaid directors finds that states expect national Medicaid enrollment will decline by 8.6% in state fiscal year (FY) 2024 as state Medicaid agencies continue to unwind pandemic-related continuous enrollment protections. After reaching record high enrollment, these estimates reflect a dramatic year-over-year decline in program…

In this JAMA Forum column, KFF’s Larry Levitt examines Medicaid’s growing political importance and the potential double whammy that could hit state Medicaid programs next year with the end of the COVID-19 public health emergency and a possible simultaneous recession.