Update on 2023-2024 Medicaid Enrollment and Spending Trends

NAHC

The Kaiser Family Foundation issue brief focusing on Medicaid enrollment and spending trends contains a significant amount of interesting and useful information, derived from a survey of Medicaid agencies that collected data on actual FY2023 expenditures and projected FY2024 spending. Importantly, the survey results predict that the state share of Medicaid financing increased by 13% in FY23 and was projected to increase by and additional 17.2% in FY24.

The significant jump in state expenditures is primarily due to the expiration of COVID-related relief that provided additional federal funds and temporary reduced the required state share of Medicaid financing. The substantial increase in state obligations for Medicaid financing may have implications for eligibility, reimbursement, and covered services as states must grapple with how to manage their Medicaid budgets in the upcoming legislative sessions.

Importantly, expiration of “maintenance of effort” requirements provides states with more opportunity to restrict Medicaid spending compared to the 2020-2023 timeframe. In light of this, though overall state fiscal health remains stable, uncertainties in future economic projections coupled with this significant increase in in the state share of spending creates the need to closely monitor Medicaid proposals around the country next year.

Read the Kaiser Brief