Medicaid enrollment increased an average 13.8% in fiscal year 2015, largely due to coverage expansions under the Affordable Care Act, while spending increased an average 13.9%, according to the latest annual survey of state Medicaid directors by the Kaiser Commission on Medicaid and the Uninsured. With only two additional states expanding coverage under the ACA in FY 2016, enrollment and spending growth are expected to slow to an average 4% and 6.9%, respectively, in FY 2016.
Among other trends, 32 states cut or froze Medicaid rates for inpatient care in FY 2015 and 30 for FY 2016. States also reported continued growth in Medicaid managed care, health and medical homes, and efforts to coordinate care and financing for beneficiaries dually eligible for Medicare, among other reforms.
Seven Medicaid expansion states planned to use increased provider taxes or fees to help fund the cost of expansion beginning in 2017, when the enhanced match rate for newly eligible enrollees drops from 100% to 95%. As of October, 30 states and the District of Columbia had expanded Medicaid eligibility under the ACA.