Medicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic

Madeline Guth, Bradley Corallo, Robin Rudowitz, and Rachel Garfield
Published: Jan 12, 2021

Appendix Table 1: Total Medicaid Enrollment, FY 2019 (In Thousands)
State	Expansion Status	Total Enrollment	Traditional Group	Expansion Group	Expansion Group (%)
United States	—	75,176	59,829	15,347	28%²
Alabama	Not Adopted	1,035	1,035	N/A	N/A
Alaska	Adopted	207	156	51	25%
Arizona	Adopted	1,880	1,453	427	23%
Arkansas	Adopted	872	603	269	31%
California	Adopted	12,875	9,073	3,802	30%
Colorado	Adopted	1,289	879	410	32%
Connecticut	Adopted	955	688	268	28%
Delaware	Adopted	219	157	63	29%
District of Columbia	Adopted	261	152	109	42%
Florida	Not Adopted	3,879	3,879	N/A	N/A
Georgia	Not Adopted	1,966	1,966	N/A	N/A
Hawaii	Adopted	317	204	114	36%
Idaho¹	Not Adopted	304	304	N/A	N/A
Illinois	Adopted	2,750	2,046	704	26%
Indiana	Adopted	1,336	1,023	313	23%
Iowa	Adopted	607	434	173	29%
Kansas	Not Adopted	374	374	N/A	N/A
Kentucky	Adopted	1,299	848	452	35%
Louisiana	Adopted	1,679	1,171	509	30%
Maine	Adopted	270	242	28	11%
Maryland	Adopted	1,229	918	311	25%
Massachusetts	Adopted	1,765	1,419	346	20%
Michigan	Adopted	2,443	1,739	704	29%
Minnesota	Adopted	1,098	895	202	18%
Mississippi	Not Adopted	675	675	N/A	N/A
Missouri¹	Not Adopted	917	917	N/A	N/A
Montana	Adopted	260	160	100	38%
Nebraska¹	Not Adopted	246	246	N/A	N/A
Nevada	Adopted	600	386	214	36%
New Hampshire	Adopted	186	131	55	30%
New Jersey	Adopted	1,668	1,116	552	33%
New Mexico	Adopted	838	580	258	31%
New York	Adopted	6,156	4,239	1,917	31%
North Carolina	Not Adopted	2,182	2,182	N/A	N/A
North Dakota	Adopted	93	72	20	22%
Ohio	Adopted	2,901	2,315	586	20%
Oklahoma¹	Not Adopted	653	653	N/A	N/A
Oregon	Adopted	967	499	468	48%
Pennsylvania	Adopted	2,869	2,093	776	27%
Rhode Island	Adopted	309	239	70	22%
South Carolina	Not Adopted	1,270	1,270	N/A	N/A
South Dakota	Not Adopted	105	105	N/A	N/A
Tennessee	Not Adopted	1,586	1,586	N/A	N/A
Texas	Not Adopted	4,255	4,255	N/A	N/A
Utah¹	Not Adopted	293	293	N/A	N/A
Vermont	Adopted	174	116	58	33%
Virginia	Adopted	1,532	1,247	284	19%
Washington	Adopted	1,760	1,190	570	32%
West Virginia	Adopted	532	369	163	31%
Wisconsin	Not Adopted	1,183	1,183	N/A	N/A
Wyoming	Not Adopted	58	58	N/A	N/A
NOTES: Totals may not sum due to rounding. 1. Idaho, Missouri, Nebraska, Oklahoma, and Utah have adopted Medicaid expansion due to successful ballots measures but have either implemented or plan to implement the expansion after FY 2019. 2. Percent of expansion group for United States is based on total enrollment in expansion states only. Expansion group enrollment is 20% in all states and DC. SOURCE: KFF Analysis of Medicaid Budget and Expenditure System (MBES) enrollment reports as of June 2020 and FMR net expenditure data as of September 2020.

Appendix Table 2: Total Medicaid Expenditures, FY 2019 (In Millions)
State	Expansion Status	Total Expenditures	Traditional Group	Expansion Group	Expansion Group (%)
United States	—	594,570	500,793	93,777	21%²
Alabama	Not Adopted	5,880	5,880	N/A	N/A
Alaska	Adopted	2,096	1,649	448	21%
Arizona	Adopted	13,168	9,939	3,229	25%
Arkansas	Adopted	6,843	5,071	1,772	26%
California	Adopted	87,856	67,855	20,001	23%
Colorado	Adopted	9,202	7,532	1,669	18%
Connecticut	Adopted	8,168	5,996	2,172	27%
Delaware	Adopted	2,246	1,782	463	21%
District of Columbia	Adopted	2,892	2,452	440	15%
Florida	Not Adopted	24,384	24,384	N/A	N/A
Georgia	Not Adopted	10,852	10,852	N/A	N/A
Hawaii	Adopted	2,178	1,609	569	26%
Idaho¹	Not Adopted	2,143	2,143	N/A	N/A
Illinois	Adopted	18,470	12,814	5,656	31%
Indiana	Adopted	12,439	9,954	2,486	20%
Iowa	Adopted	5,200	4,157	1,042	20%
Kansas	Not Adopted	3,602	3,602	N/A	N/A
Kentucky	Adopted	10,208	7,218	2,989	29%
Louisiana	Adopted	11,642	8,504	3,138	27%
Maine	Adopted	2,867	2,748	119	4%
Maryland	Adopted	11,730	9,011	2,719	23%
Massachusetts	Adopted	17,413	15,202	2,211	13%
Michigan	Adopted	18,258	13,787	4,471	24%
Minnesota	Adopted	12,721	10,876	1,845	15%
Mississippi	Not Adopted	5,507	5,507	N/A	N/A
Missouri¹	Not Adopted	10,535	10,535	N/A	N/A
Montana	Adopted	1,858	1,140	718	39%
Nebraska¹	Not Adopted	2,142	2,142	N/A	N/A
Nevada	Adopted	3,979	2,697	1,282	32%
New Hampshire	Adopted	1,985	1,730	255	13%
New Jersey	Adopted	15,909	12,615	3,293	21%
New Mexico	Adopted	5,263	3,793	1,470	28%
New York	Adopted	58,094	48,331	9,763	17%
North Carolina	Not Adopted	13,596	13,596	N/A	N/A
North Dakota	Adopted	1,164	912	252	22%
Ohio	Adopted	23,466	19,456	4,010	17%
Oklahoma¹	Not Adopted	4,760	4,760	N/A	N/A
Oregon	Adopted	9,427	6,447	2,980	32%
Pennsylvania	Adopted	32,080	27,379	4,700	15%
Rhode Island	Adopted	2,586	2,144	442	17%
South Carolina	Not Adopted	6,306	6,306	N/A	N/A
South Dakota	Not Adopted	899	899	N/A	N/A
Tennessee	Not Adopted	10,092	10,092	N/A	N/A
Texas	Not Adopted	40,026	40,026	N/A	N/A
Utah¹	Not Adopted	2,724	2,724	N/A	N/A
Vermont	Adopted	1,638	1,410	228	14%
Virginia	Adopted	11,307	9,713	1,594	14%
Washington	Adopted	13,128	8,709	4,420	34%
West Virginia	Adopted	3,926	2,994	932	24%
Wisconsin	Not Adopted	9,133	9,133	N/A	N/A
Wyoming	Not Adopted	584	584	N/A	N/A
NOTES: Totals may not sum due to rounding. 1. Idaho, Missouri, Nebraska, Oklahoma, and Utah have adopted Medicaid expansion due to successful ballots measures but have either implemented or plan to implement the expansion after FY 2019. 2. Percent of expansion group for United States is based on total expenditures in expansion states only. Expansion group expenditures are 16% of total spending in all states and DC. SOURCE: KFF Analysis of Medicaid Budget and Expenditure System (MBES) enrollment reports as of June 2020 and FMR net expenditure data as of September 2020.

Appendix Table 3: Spending per Enrollee, FY 2019
State	Expansion Status	Total Spending per Enrollee	Traditional Group	Expansion Group
United States	—	7,910	8,370	6,110²
Alabama	Not Adopted	5,680	5,680	N/A
Alaska	Adopted	10,110	10,570	8,720
Arizona	Adopted	7,000	6,840	7,560
Arkansas	Adopted	7,850	8,410	6,580
California	Adopted	6,820	7,480	5,260
Colorado	Adopted	7,140	8,570	4,080
Connecticut	Adopted	8,550	8,720	8,110
Delaware	Adopted	10,230	11,390	7,370
District of Columbia	Adopted	11,070	16,110	4,040
Florida	Not Adopted	6,290	6,290	N/A
Georgia	Not Adopted	5,520	5,520	N/A
Hawaii	Adopted	6,870	7,900	5,010
Idaho¹	Not Adopted	7,050	7,050	N/A
Illinois	Adopted	6,720	6,260	8,030
Indiana	Adopted	9,310	9,730	7,940
Iowa	Adopted	8,570	9,590	6,020
Kansas	Not Adopted	9,620	9,620	N/A
Kentucky	Adopted	7,860	8,520	6,620
Louisiana	Adopted	6,930	7,260	6,170
Maine²	Adopted	10,620	11,380	4,170
Maryland	Adopted	9,540	9,810	8,740
Massachusetts	Adopted	9,870	10,720	6,390
Michigan	Adopted	7,470	7,930	6,350
Minnesota	Adopted	11,590	12,150	9,110
Mississippi	Not Adopted	8,160	8,160	N/A
Missouri¹	Not Adopted	11,490	11,490	N/A
Montana	Adopted	7,150	7,130	7,190
Nebraska¹	Not Adopted	8,720	8,720	N/A
Nevada	Adopted	6,630	6,990	5,980
New Hampshire	Adopted	10,670	13,250	4,590
New Jersey	Adopted	9,540	11,310	5,970
New Mexico	Adopted	6,280	6,540	5,690
New York	Adopted	9,440	11,400	5,090
North Carolina	Not Adopted	6,230	6,230	N/A
North Dakota	Adopted	12,580	12,640	12,330
Ohio	Adopted	8,090	8,410	6,840
Oklahoma¹	Not Adopted	7,290	7,290	N/A
Oregon	Adopted	9,750	12,920	6,360
Pennsylvania	Adopted	11,180	13,080	6,060
Rhode Island	Adopted	8,370	8,950	6,360
South Carolina	Not Adopted	4,970	4,970	N/A
South Dakota	Not Adopted	8,590	8,590	N/A
Tennessee	Not Adopted	6,360	6,360	N/A
Texas	Not Adopted	9,410	9,410	N/A
Utah¹	Not Adopted	9,300	9,300	N/A
Vermont	Adopted	9,410	12,110	3,950
Virginia²	Adopted	7,380	7,790	5,600
Washington	Adopted	7,460	7,320	7,760
West Virginia	Adopted	7,380	8,110	5,720
Wisconsin	Not Adopted	7,720	7,720	N/A
Wyoming	Not Adopted	10,060	10,060	N/A
NOTES: Totals may not sum due to rounding. 1. Idaho, Missouri, Nebraska, Oklahoma, and Utah have adopted Medicaid expansion due to successful ballots measures but have either implemented or plan to implement the expansion after FY 2019. 2. Due to Virginia and Maine implementing expansion in January 2019 (although Maine allowed for retroactive enrollment as early as July 2018), estimates of spending per enrollee for the expansion group are likely an underestimate. SOURCE: KFF Analysis of Medicaid Budget and Expenditure System (MBES) enrollment reports as of June 2020 and FMR net expenditure data as of September 2020.

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Medicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic

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