Trends in State Medicaid Programs: Looking Back and Looking Ahead

Conclusion

Medicaid is the nation’s primary public health insurance program for people with low incomes covering over 70 million Americans. Each year, states make a range of policy changes to Medicaid to comply with new federal rules and to address an array of policy goals. Reviewing the annual survey findings over the last 15 years shows just how dynamic and ever-changing Medicaid programs are, as they continue to evolve and respond to changes in the economy, state budgets and priorities, new opportunities and the needs of the beneficiaries they serve. The ACA brought historic changes to Medicaid eligibility and enrollment that built upon earlier actions taken in some states to expand coverage as well as simplify and streamline enrollment processes. Looking ahead, states will likely continue to pursue innovations in delivery system and payment reform, taking advantage of new federal support and innovations in technology.  Future surveys will continue to track changes in enrollment and spending as well continued changes related to delivery and payment reforms as well as other key state policy changes in Medicaid.