CHA News Article

Report Outlines Medicaid Enrollment, Spending Growth
Focus on fiscal years 2015 and 2016

The Kaiser Commission on Medicaid and the Uninsured (KCMU) has released a report that provides an overview of Medicaid enrollment and spending growth with a focus on fiscal years (FY) 2015 and 2016. Findings are based on interviews and data provided by state Medicaid directors as part of the 15th annual survey of Medicaid directors in all 50 states and the District of Columbia, conducted by KCMU and Health Management Associates. Beginning in FY 2014, policy changes introduced by the Affordable Care Act (ACA) have been driving Medicaid enrollment and spending growth.

Key report findings reveal:

  • Medicaid enrollment and spending increased substantially in FY 2015, the first full year of implementation of the major ACA coverage expansions. Across all 50 states and DC, Medicaid enrollment increased an average of 13.8 percent in FY 2015, largely due to the ACA coverage expansions. Driven by growth in enrollment, total Medicaid spending increased by 13.9 percent on average in FY 2015.
  • In FY 2015, Medicaid enrollment and total Medicaid spending growth in expansion states far exceeded growth in non-expansion states. Expansion states reported Medicaid enrollment and total spending growth nearly three times the rate of non-expansion states.
  • State general fund Medicaid spending across all states grew at more modest levels in FY 2015 than total Medicaid spending and Medicaid enrollment growth, but there was variation across expansion and non-expansion states. Across expansion states, state general fund Medicaid spending grew at more modest levels compared to total Medicaid spending – primarily due to the enhanced federal match rate for those newly eligible for coverage.
  • Total Medicaid enrollment and spending growth is projected to slow in FY 2016; looking ahead, states will monitor the effects of the ACA and other payment and delivery system reforms on spending. States experienced the major effects of the ACA in FY 2015; FY 2016 projections for Medicaid enrollment and total spending across all states indicate much slower growth on average than in FY 2015. Subsequently, the difference in enrollment and total spending growth rates across expansion and non-expansion states is projected to narrow in FY 2016.

The full report is available on the Kaiser Family Foundation website.