Health Care

Medicaid enrollment likely to decline, spending to rise

States are still adjusting to the end of Covid-era policies.
North Carolina Gov. Roy Cooper (D) signs a Medicaid expansion law at the Executive Mansion on Monday, March 27, 2023, in Raleigh, N.C. (AP Photo/Hannah Schoenbaum)

Following significant growth during the pandemic, states expect in this fiscal year that national Medicaid enrollment will decline for the second straight year and spending will rise, as states continue to adjust to the end of Covid-era federal incentives designed to keep low-income people insured.

According to an annual survey of state Medicaid directors, released Wednesday by the nonpartisan health policy research organization KFF, states anticipate national Medicaid enrollment to decline by about 4% and state Medicaid spending to rise by 7% in Fiscal Year 2025, following a larger enrollment decline and state spending increase in FY 2024.

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