Health Affairs

By: Allan Baumgarten and Katherine Hempstead

The COVID-19 pandemic and related economic dislocation are having a major impact on state budgets, particularly their Medicaid programs.  Medicaid is inherently counter-cyclical, meaning that enrollment and spending increase in response to economic downturns.  Medicaid enrollment will grow as workers lose jobs and coverage.  Forecasts range from 5 million to 15 million or more individuals being added to the Medicaid rolls by the end of 2020, in addition to the roughly 72 million enrollees in April 2020.  Data recently compiled by the Georgetown Center for Children and Families shows an average increase in Medicaid enrollment of about 5 percent since February for 22 states, with ranges from less than 3 percent in some states to nearly 9 percent in others.

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