State Medicaid programs added a total of almost 3.3 million people to their rolls in June 2009 compared to June 2008, representing the largest numerical one-year increase in the nation's history, according to the Kaiser Family Foundation's (KFF) Commission on Medicaid and the Uninsured. This influx increased the national June 2009 monthly Medicaid enrollment by 7.5 percent over June 2008 to reach 46.9 million people.
Medicaid enrollment growth occurred across the board, with every state seeing an increase for the first time since the early 1990s. In fact, 32 states experienced growth that was at least twice as fast as the previous year, and 13 states endured double-digit percentage growth from June 2008 to June 2009. This growth mirrored the nation's economic woes as unemployment rose from 5.5 percent in June 2008 to 9.5 percent in June 2009. Monthly Medicaid enrollment growth has accelerated in each six-month period since the recession began in December 2007. In the most recent six months (December 2008 to June 2009), Medicaid programs added 2.1 million people--the largest increase since the program's implementation in the late 1960s.
The commission expects this upward spike to continue given historical trends in Medicaid enrollment and the ongoing impact of the recession. "If Medicaid enrollment follows the pattern of prior recessions, the second half of 2009 would be expected to produce even stronger enrollment growth," says Kaiser.
In another recent Kaiser survey, state Medicaid directors in 44 states and the District of Columbia reported experiencing unexpectedly high program enrollment and a corresponding increase in fiscal year 2010 spending. At least 29 states also reported that additional cuts in provider payments and program benefits could be made to balance the books. Enhanced federal funding through the American Recovery and Reinvestment Act of 2009 is slated to expire on Dec. 31, 2010.