Despite state-by-state variation, Medicaid spending is expecting to increase by billions of dollars through 2022, according to a study from the Kaiser Commission of Medicaid and the Uninsured.

Under the Supreme Court’s Affordable Care Act decision, states are allowed to decide whether to accept federal funding to grow their Medicaid rolls. If all states expand, state Medicaid spending nationally would go up by $76 billion over the next nine years, or an increase of under 3%. Federal Medicaid spending would rise by $952 billion, a 26% increase.  Even if no states adopt the Medicaid expansion plan, Medicaid enrollment would be expected to add 5.7 million new enrollees by 2022, report authors point out. 

States could save $18 billion if they adopt the Medicaid expansion since they would experience declines in uncompensated care from people without insurance being in a hospital, the study says.

It’s likely long-term care operators will have varied experiences if their respective states expand Medicaid: While it might make more people eligible for benefits, including skilled nursing services, hospitals are expected to receive around 40% of the increase in federal and state expenditures.

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