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Survey: States Face Medicaid Budget Cuts, Increased Enrollment

As states make new budget projections, many are expecting Medicaid cuts due to rising Medicaid spending and enrollment, according to early survey results from the Kaiser Family Foundation.

Of the 38 states that answered the survey, most anticipated relatively flat Medicaid enrollment growth before the COVID-19 public health emergency. However, the implications of the unexpected pandemic upended previous budget projections as Medicaid enrollment is shown to grow rapidly during economic downturns and uncertainty. KFF’s recent study also found:

  • almost all states are estimating higher enrollment than projected before the pandemic and continued Medicaid growth for fiscal years 2020 and 2021;
  • states attribute the increase in growth to the downfall in the economy and increased uncertainty;
  • more than half of the respondent states that projected budgets before the crisis now estimate spending growth for fiscal year 2020 will be higher than original projections; and
  • nearly all the respondent states with budget projections before COVID-19 now anticipate shortfalls are “almost certain.”

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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