States reported declines in Medicaid enrollment and modest growth in total Medicaid spending for fiscal year 2019, according to the latest annual Kaiser Family Foundation survey of state Medicaid directors. A stronger economy as well as new enrollment systems and enhanced verifications contributed to declines in Medicaid enrollment, according to the report. Total spending growth slowed to 2.9% in FY 2019 primarily due to enrollment declines; however, for FY 2020, states project a more typical growth level of 6.2% due to higher costs for prescription drugs, provider rate increases and costs for the elderly and people with disabilities (including increased utilization of long-term services and supports). Looking ahead, the report said that economic conditions and the outcomes of federal and state elections in November 2020 are likely to have major implications for Medicaid, state budgets and enrollees as debate about Medicaid expansion, demonstration waivers, the Affordable Care Act and broader health reform continue to be a major focus for candidates and voters.

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