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October 2009 St@teside

Kaiser Releases Medicaid Directors' Survey

The Kaiser Family Foundation just released its annual 50-state Medicaid Directors’ survey, “The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession.”  This year’s report covers the major cross-cutting environmental factors that have affected state Medicaid programs over the last year, including rising unemployment, rising Medicaid enrollment, sharply falling state revenue, and a significant temporary increase in federal funding.

The findings of the report include:

  • Both spending and enrollment growth outstripped expectations in fiscal year (FY) 2009. Spending increased 7.9 percent and enrollment increased 5.4 percent, the highest rate in six years. Enrollment is expected to increase 6.6 percent in FY 2010.
  • The American Recovery and Reinvestment Act prevented major cuts in FY 2009. Fourteen states rescinded eligibility cuts due to the requirement in the bill that states receiving federal funds not reduce eligibility. The funding also prevented or minimized cuts to provider reimbursement and benefits in about two-thirds of states.
  • Even in difficult budget times, more than half of states are simplifying enrollment and program administration to enable more residents to take advantage of the Medicaid program.
  • A handful of states – including Colorado, Maryland, New York, Oklahoma and Wisconsin – are actively increasing their rolls through program expansion.

Unfortunately, analysis in the report points to continued hardships for states in the coming year. With Medicaid spending expected to increase by at least 6.3 percent, there is great concern about additional budget shortfalls. And, while states officials have expressed enthusiasm for using the program to expand coverage through federal reform, most are concerned about increasing the financial burden on states. It’s going to be another tough year for states.