Medicaid is the largest health insurance program in the United States, covering both acute and long-term care services for over 66 million low-income Americans—children and their parents, as well as elderly and disabled individuals.1 But having long served as the primary safety-net insurer for many of the most vulnerable Americans, Medicaid is undergoing its biggest change since its inception five decades ago because of the implementation of the Affordable Care Act.2 These changes will affect which individuals—and how many—may enroll in the program and how care is delivered.3 Policymakers in the 50 states and the District of Columbia, cautious about Medicaid’s claim on state revenue, need to know how the changes will affect state budgets and residents’ health.
This report, the first in a series, focuses on the impact of Medicaid on the states, including trends in spending and enrollment, and the anticipated effects of the Affordable Care Act. Tracking these trends is critical, particularly as the rollout of the new health law continues.