State officials are reporting that Medicaid enrollment stayed flat, year over year, though most are planning for at least moderate increases on spending for nursing homes’ largest source of funding.
That’s according to the latest survey of 50 state Medicaid directors, released by the Kaiser Family Foundation on Thursday. Directors attribute the Medicaid enrollment stability to the strengthening economy, with fewer individuals qualifying for the program, along with new systems to verify enrollees’ eligibility.
Average combined federal and state spending on Medicaid ticked up by 4.2% in fiscal 2018 (which ended Sept. 30), about on par with previous years’ growth. States on average expect a 5.3% uptick in Medicaid spending for FY 2019, Kaiser reported.
Authors attribute the gap between spending and enrollment growth to higher costs for prescription drugs and increased spending on long-term care for seniors and those with disabilities, as well as many states choosing to raise payment rates for nursing facilities and other provider types. Also, fewer children enrolled in the program compared to older adults, who have much more expensive care needs.
The number of states employing at least one strategy to expand the number of people who are receiving long-term services and supports in home or community-based settings will increase from 46 to 48 next year.
Kaiser noted that upcoming federal and state elections will have a huge impact on the future of Medicaid. On the federal side, the outcome will determine whether Congress takes up legislation to change the Affordable Care Act, or reform Medicaid financing. Also, 36 states have gubernatorial elections this year, which will determine expansion considerations. Another three states — Idaho, Nebraska and Utah — also will ask voters to weigh in on Medicaid expansion.
