This fact sheet examines how an economic downturn increases state Medicaid program enrollment and costs at the same time that states face new budget constraints, as well as possible policy responses.

The economic downturn has strained family finances and led some Americans to cut back on medications and medical care. The Foundation has a number of resources that shed light on how Americans and states are faring and provide background on the uninsured, employer-sponsored health insurance costs, trends in states’ Medicaid enrollment and spending and prior efforts to support the Medicaid program during a slumping economy.

This eighth annual 50-state survey on Medicaid and state budget actions finds enrollment began to rise in fiscal year 2008 with states expecting even larger increases for fiscal year 2009.  With the increased enrollment, Medicaid spending is also rising more rapidly than in the recent past.

Gary Claxton, a Kaiser Family Foundation vice president, testified about state-based health reform efforts as part of the Senate Finance Committee's Prepare For Launch Health Reform Summit. His testimony examines the role of Medicaid and the State Children's Health Insurance Program, as well as the way various federal laws and policies may limit innovation at the state level.

In the fourth installment of the new Kaiser Family Foundation series, "Pulling It Together, from Drew Altman," Kaiser's President and CEO draws on his personal experience in state and federal government and from Kaiser's research to provide some perspectives on state health reform. The essay looks at obstacles and opportunities for reform in the states, and how a small number of pacesetting states could serve as laboratories for a national effort.

“Kaiser Fast Facts” features “QuickTakes” and “Kaiser Slides” – two tools that provide direct access to facts, data and slides about the nation's health care system and programs, in an easy-to-use format. “QuickTakes” presents an inventory of facts-at-a-glance and "Kaiser Slides" allows Web visitors to freely view, download and print graphics and tables of health policy statistics and trends.

This analysis finds that every one percentage point rise in the unemployment rate leads to a 1.1 million increase in the uninsured population and a one million increase in Medicaid and SCHIP enrollment. Another report analyzes the history of Medicaid during recent economic downturns.

This analysis projects the implications of an economic downturn for health coverage and state programs. 

This brief analyzes results from annual 50-state budget surveys of Medicaid directors from 2003 to 2007 to determine how past actions by states and the federal government may impact Medicaid programs during the current economic downturn.

This issue brief finds that Medicaid spending declined for the first time in the program’s 40-plus year history in Federal Fiscal Year (FY) 2006, falling by 0.2 percent.