Medicaid’s Future

Ten months into the unwinding of the Medicaid continuous enrollment provision, states have reported renewal outcomes for half of all enrollees whose eligibility needs to be reviewed during the unwinding period, including 34% (32.1 million) who have had their coverage renewed, and 17% (16.2 million) who have been disenrolled, according…

As the start of 2024, many issues are at play that will affect Medicaid coverage, financing, and access. This issue brief provides context for these Medicaid issues and highlights key issues to watch in the year ahead.

This issue brief analyzes Medicaid enrollment and spending trends for FY 2023 and FY 2024, based on data provided by state Medicaid directors as part of the 23rd annual survey of Medicaid directors in states and the District of Columbia.

State legislatures are currently gathering to develop new budgets for state fiscal year (FY) 2025. Heading into this budget cycle, state fiscal conditions are shifting, with state revenues starting to decline following steep revenue growth during the pandemic. This issue brief examines trends in state fiscal conditions and discusses how state budgets and macroeconomic conditions may affect individuals and state Medicaid programs.

This video provides an overview of the people covered by Medicaid and how Medicaid funds are distributed across enrollment groups and on a per enrollee basis. The video also highlights the implications of reducing federal Medicaid funds through a block grant or per capita cap.

This Waiver Watch summarizes the recent history of work requirements, the current status of Georgia’s waiver, and key state and federal issues to watch.

Medicaid is the primary program providing comprehensive coverage of health care and long-term services and supports to more than 90 million low-income people in the United States. In 2023, Medicaid programs are facing new challenges and millions of enrollees are at risk of losing coverage as states unwind the continuous enrollment provision that was put in place early in the pandemic to ensure stable coverage.

KFF’s survey examines adults who had Medicaid coverage in early 2023, just before states resumed eligibility checks and disenrollments after pandemic-era protections ended. Nearly a quarter (23%) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year.

This issue brief provides an overview of how Section 1115 waivers have been used to address the health-related social needs of enrollees, including a summary of recent approvals for eight states.

The pandemic continuous enrollment provision and other research show that continuous eligibility reduces Medicaid disenrollment and “churn” rates and helps to ensure stable coverage. As many Medicaid enrollees are currently experiencing disruptions in coverage as a result of the Medicaid unwinding, a number of states are pursuing strategies to help promote continuity of coverage, including through unwinding waivers and Section 1115 demonstration waivers. This Waiver Watch summarizes approved and pending Section 1115 waivers with continuous eligibility provisions for children and adults in Medicaid.