Medicaid Rolls Surge, Adding to Budget Woes

Read Stateline coverage of the latest state action on coronavirus.

Many of the tens of millions of Americans who have lost their health insurance along with their jobs are enrolling in Medicaid — and with state budgets decimated by the pandemic, state officials worry they won’t have the money to pay for their health care.

Nearly 27 million Americans could lose their employer-sponsored health insurance over the course of the pandemic, the Kaiser Family Foundation projected last month. Medicaid, the joint federal-state health plan for low-income Americans, already consumes more than a fifth of state budgets.

“When the economy goes down, people need Medicaid and other supports more than ever,” said Matt Anderson, assistant commissioner of Minnesota’s Health Care Administration and the state’s Medicaid director. “But for Minnesota and all other states, that is happening at the exact moment our budgets are suffering.”

At the same time, officials worry that if people delay or decline treatment because they aren’t covered by Medicaid or other insurance, the coronavirus will spread.

States are pushing for more federal money so they can avoid an array of measures to cut Medicaid costs, from eliminating some of the optional benefits they now provide to reducing the already low reimbursement rates paid to Medicaid providers.

Enrollment Increase

Georgetown University’s Center for Children and Families late last month published an analysis of public data on Medicaid enrollment in 21 states from February through April. It found a 2.8% overall increase in enrollment.

The center was able to get May totals for three states, all of which showed a continued upward trend. Minnesota’s four-month increase was 8.4%, Kentucky’s 8.1% and North Carolina’s 3.4%. (The federal Centers for Disease Control and Prevention publishes monthly Medicaid enrollment data, but it lags a few months. The most recent numbers are from January, prior to the impact of the pandemic.)

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