Hospitals

Growth of Medicaid in 2012 continues to drop with enrollment

In a sign of the improving national economy, Medicaid spending growth this year slowed to 2 percent as enrollment in the state-federal health insurance program for the poor also slowed for the third consecutive year, according to a report released Thu…

In a sign of the improving national economy, Medicaid spending growth this year slowed to 2 percent as enrollment in the state-federal health insurance program for the poor also slowed for the third consecutive year, according to a report released Thursday.

In 2011, Medicaid spending soared by nearly 10 percent, which helped put the entitlement program in the crosshairs of politicians looking to lower the federal deficit and ease pressure on state budgets. The increase this year is the smallest since 2006, said the report, based on a 50-state survey by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. (KHN is an editorially independent program of the foundation.)

Enrollment growth in Medicaid slowed to 3.2 percent this year, down from 4.4 percent last year and 7.2 percent in 2010. There are 62 million people in the program.

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Other factors affecting spending growth included actions by states to cuts benefits and reduce reimbursement rates to hospitals and doctors, and changes in how patients receive care.

States are projecting the slowdown in enrollment to continue in 2013, the report says. Spending, however, is expected to increase 3.8 percent.

“We believe this is the second slowest spending growth in the history of the program,” said Vernon Smith, a co-author of the study and managing principal at consulting firm Health Management Associates. Kaiser has done the annual Medicaid survey since 1998.  “States are working very hard to improve value and slow the rate of growth of Medicaid.”

In the past year, states had extra incentive to control spending because $100 billion in extra federal funding to state Medicaid programs as part of the federal stimulus law ended in June 2011, Smith said.

Among the cost cutting efforts:

— Forty-five states froze or lowered provider rates in 2012 and 42 states reported plans to do so in 2013.

–Eighteen states in 2012 and eight states in the 2013 budget year starting in July reported eliminating, reducing or restricting benefits. Limits on dental and vision services, personal care services and medical supplies were most frequently reported.

— This year, 20 states reported expanded use of managed care, primarily by extending it into new counties or by adding new categories of recipients, such as the disabled.  For 2013, 35 states reported they were expanding managed care, including 10 states that indicated plans to implement managed long- term care. Many states contract management of Medicaid services to private insurers.

President Barack Obama and GOP nominee Mitt Romney have opposing plans for the program. Obama’s health law will add as many as 17 million people to the program starting in 2014 by expanding eligibility to 133 percent of federal poverty, or $31,000 for a family of four. Romney wants to give states greater powers to reduce eligibility and benefits and cut federal funding by $100 billion a year.

The federal government pays for about 57 percent of the $400 billion Medicaid program.

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