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Survey Shows Trends in State Medicaid Spending

States saw Medicaid enrollment declines and modest spending growth in 2019, but anticipate slight enrollment increases and higher spending in 2020, according to the Kaiser Family Foundation annual survey of state Medicaid directors in all 50 states and the District of Columbia.

In 2019, enrollment declined 1.7 percent, and respondents anticipate little change in 2020, with a 0.8 percent increase. Several factors might contribute to this trend, including:

  • a strong economy;
  • changes in renewal processes;
  • updated eligibility systems; and
  • enhanced verification and data matching efforts.

Medicaid spending grew at a slow pace (2.9 percent) in 2019, but is expected to increase to 6.2 percent growth in 2020. Compared with total spending growth, the state share of Medicaid spending grew at a slower rate, a trend that is expected to continue in 2020.

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


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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