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Medicaid Directors Survey Examines COVID-19 Impact, Equity Efforts

The Kaiser Family Foundation’s (KFF’s) 21st Annual Medicaid Director Survey results illustrate significant changes to Medicaid programs related to the COVID-19 public health emergency (PHE). The results also show increased efforts to address social determinants of health (SDOH) and improve health equity.

Specifically, the survey found:

  • more than half of responding states expanded SDOH projects, particularly housing, due to the pandemic;
  • 75 percent of respondents acknowledged their plans to address racial and ethnic disparities in health;
  • 22 states reported new or enhanced Medicaid benefits for fiscal year (FY) 2021, and 29 states will enhance benefits for FY 2022. Enhancements include expanding behavioral health services, improving reproductive and postpartum health, examining permanent telehealth solutions, and more; and
  • in states with Medicaid managed care contracts, at least 75 percent of Medicaid beneficiaries were enrolled in managed care organizations as of July 2021.

Further, KFF released a companion survey examining Medicaid spending for FYs 2021 and 2022 and found several trends:

  • states expect Medicaid enrollment growth to slow to 4.5 percent in FY 2022 (down from 10.3 percent in FY 2021);
  • responding states assume total Medicaid spending growth will slow to 7.3 percent in FY 2022 compared with 11.4 percent in FY 2021 due to decreased enrollment growth; and
  • as the federal PHE is slated to expire in 2022, states are preparing for a sharper growth in the state share of Medicaid spending when the increased Federal Medical Assistance Percentage concludes.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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