During fiscal year 2025, Medicaid enrollment dipped while spending grew, according to a Nov. 13 KFF brief.
The nonprofit organization hired Health Management Associates to consult state Medicaid directors across the country on recent trends. Florida, Kansas and Mississippi did not respond to the survey.
States began “unwinding” from the COVID-era continuous enrollment provision toward the end of fiscal year 2023 and enhanced federal funding cooled around the same time, ultimately affecting long-term enrollment and spending trends.
Here are four things to know about the state of Medicaid today:
1. Medicaid enrollment dropped by 7.6% in fiscal year 2025. Medicaid enrollment is expected to flatten next year, with growth at only 0.2%.
2. Total spending growth was 8.6% and is expected to slow a bit next year to 7.9%. This spending can be attributed to rate increases, greater health needs, and steeper costs for long-term care, pharmacy and behavioral health.
3. State Medicaid spending growth reached 12.2% and is expected to slow to 8.5% for fiscal year 2026.
4. Nearly two-thirds of surveyed state directors said the chance of a Medicaid budget shortfall was at least 50% possible.
