Selected SLC Research


Policy Analysis | August 1, 2014

How has Medicaid spending changed in the SLC member states in the past three years?

Between FY 2010 and FY 2012, Medicaid expenditures outgrew other areas of state budgets by a large margin in most of the SLC states. In FY 2012, state general fund Medicaid expenditures were an average of 57.4 percent higher in the SLC states than in FY 2010. During this same period, non-Medicaid expenditures only increased by an average of 5.1 percent. Non-Medicaid expenditures include elementary and secondary education, higher education, public assistance, corrections, transportation, and all other non-capital expenditures.

It should be noted, however, that during these fiscal years many states exhausted the use of federal ARRA funds and returned to a lower federal matching rate for Medicaid. During the preceding budget years while states were experiencing reduced revenues, many states used ARRA funds to supplant state funds in order to maintain their level of service; upon exhaustion of the ARRA funds, state funds were necessary to refill these budget holes.

The data for these calculations comes from the National Association of State Budget Officers (NASBO) FY2010-2012 State Expenditure Report and FY 2011-2013 State Expenditure Report. Classification of funds is not uniform across the states; explanations of notable differences are available in the NASBO reports.

SLC Member States' Medicaid and Non-Medicaid Spending, FY 2010-12

General State Funds Other State Funds Federal Funds Total Funds
State Expenditures ($ in millions) FY 2010 FY 2012 % Change from FY10 FY 2010 FY 2012 % Change from FY10 FY 2010 FY 2012 % Change from FY10 FY 2010 FY 2012 % Change from FY10
Alabama                        
Medicaid *** $315 $575 82.5% $1,122 $1,257 12.0% $3,957 $3,795 -4.1% $5,394 $5,627 4.3%
Non-Medicaid $6,273 $6,699 6.8% $3,841 $6,013 56.5% $4,705 $5,513 17.2% $14,819 $18,225 23.0%
Total $6,588 $7,274 10.4% $4,963 $7,270 46.5% $8,662 $9,308 7.5% $20,213 $23,852 18.0%
Arkansas                        
Medicaid $602 $630 4.7% $179 $652 264.2% $3,209 $3,142 -2.1% $3,990 $4,424 10.9%
Non-Medicaid $3,621 $3,952 9.1% $8,537 $9,041 5.9% $3,685 $3,136 -14.9% $15,843 $16,129 1.8%
Total $4,223 $4,582 8.5% $8,716 $9,693 11.2% $6,894 $6,278 -8.9% $19,833 $20,553 3.6%
Florida                        
Medicaid * $2,564 $4,010 56.4% $3,166 $4,330 36.8% $12,189 $10,929 -10.3% $17,919 $19,269 7.5%
Non-Medicaid $18,652 $19,043 2.1% $7,446 $8,598 15.5% $16,769 $13,686 -18.4% $42,867 $41,327 -3.6%
Total $21,216 $23,053 8.7% $10,612 $12,928 21.8% $28,958 $24,615 -15.0% $60,786 $60,596 -0.3%
Georgia                        
Medicaid $1,663 $2,641 58.8% $389 $605 55.5% $5,832 $5,599 -4.0% $7,884 $8,845 12.2%
Non-Medicaid $12,898 $14,599 13.2% $9,992 $10,181 1.9% $8,809 $6,870 -22.0% $31,699 $31,650 -0.2%
Total $14,561 $17,240 18.4% $10,381 $10,786 3.9% $14,641 $12,469 -14.8% $39,583 $40,495 2.3%
Kentucky                        
Medicaid $811 $1,319 62.6% $383 $373 -2.6% $4,499 $4,090 -9.1% $5,693 $5,782 1.6%
Non-Medicaid $7,639 $8,015 4.9% $6,631 $7,255 9.4% $5,978 $4,597 -23.1% $20,248 $19,867 -1.9%
Total $8,450 $9,334 10.5% $7,014 $7,628 8.8% $10,477 $8,687 -17.1% $25,941 $25,649 -1.1%
Louisiana                        
Medicaid $722 $1,770 145.2% $479 $598 24.8% $5,634 $4,863 -13.7% $6,835 $7,231 5.8%
Non-Medicaid $8,094 $6,574 -18.8% $9,889 $7,195 -27.2% $6,225 $5,753 -7.6% $24,208 $19,522 -19.4%
Total $8,816 $8,344 -5.4% $10,368 $7,793 -24.8% $11,859 $10,616 -10.5% $31,043 $26,753 -13.8%
Mississippi                        
Medicaid ** $139 $73 -47.5% $849 $1,050 23.7% $3,199 $3,182 -0.5% $4,187 $4,305 2.8%
Non-Medicaid $4,315 $4,422 2.5% $4,927 $4,543 -7.8% $8,910 $4,763 -46.5% $18,152 $13,728 -24.4%
Total $4,454 $4,495 0.9% $5,776 $5,593 -3.2% $12,109 $7,945 -34.4% $22,339 $18,033 -19.3%
Missouri                        
Medicaid *** $1,422 $1,719 20.9% $1,921 $2,224 15.8% $4,019 $4,245 5.6% $7,362 $8,188 11.2%
Non-Medicaid $6,143 $6,219 1.2% $4,449 $5,663 27.3% $4,724 $3,294 -30.3% $15,316 $15,176 -0.9%
Total $7,565 $7,938 4.9% $6,370 $7,887 23.8% $8,743 $7,539 -13.8% $22,678 $23,364 3.0%
North Carolina                        
Medicaid $2,319 $3,517 51.7% $1,364 $468 -65.7% $8,113 $7,535 -7.1% $11,796 $11,520 -2.3%
Non-Medicaid $16,194 $16,678 3.0% $11,219 $10,739 -4.3% $9,050 $6,978 -22.9% $36,463 $34,395 -5.7%
Total $18,513 $20,195 9.1% $12,583 $11,207 -10.9% $17,163 $14,513 -15.4% $48,259 $45,915 -4.9%
Oklahoma                        
Medicaid $550 $1,225 122.7% $617 $1,093 77.1% $3,141 $2,686 -14.5% $4,308 $5,004 16.2%
Non-Medicaid $4,205 $5,268 25.3% $5,587 $6,481 16.0% $6,215 $4,032 -35.1% $16,007 $15,781 -1.4%
Total $4,755 $6,493 36.6% $6,204 $7,574 22.1% $9,356 $6,718 -28.2% $20,315 $20,785 2.3%
South Carolina                        
Medicaid ** $529 $640 21.0% $546 $719 31.7% $3,521 $3,426 -2.7% $4,596 $4,785 4.1%
Non-Medicaid $4,617 $4,877 5.6% $6,233 $6,445 3.4% $4,170 $5,858 40.5% $15,020 $17,180 14.4%
Total $5,146 $5,517 7.2% $6,779 $7,164 5.7% $7,691 $9,284 20.7% $19,616 $21,965 12.0%
Tennessee                        
Medicaid *** $1,632 $2,792 71.1% $322 $534 65.8% $6,227 $6,007 -3.5% $8,181 $9,333 14.1%
Non-Medicaid $8,282 $8,893 7.4% $5,162 $5,140 -0.4% $6,724 $6,799 1.1% $20,168 $20,832 3.3%
Total $9,914 $11,685 17.9% $5,484 $5,674 3.5% $12,951 $12,806 -1.1% $28,349 $30,165 6.4%
Texas                        
Medicaid * $6,420 $10,115 57.6% $0 $1,697 1697.0% $15,269 $16,126 5.6% $21,689 $27,938 28.8%
Non-Medicaid $33,054 $33,759 2.1% $14,845 $14,195 -4.4% $21,404 $15,410 -28.0% $69,303 $63,364 -8.6%
Total $39,474 $43,874 11.1% $14,845 $15,892 7.1% $36,673 $31,536 -14.0% $90,992 $91,302 0.3%
Virginia                        
Medicaid $2,590 $3,569 37.8% $0 $0 0.0% $3,963 $3,465 -12.6% $6,553 $7,034 7.3%
Non-Medicaid $12,399 $13,417 8.2% $15,001 $15,943 6.3% $5,365 $5,747 7.1% $32,765 $35,107 7.1%
Total $14,989 $16,986 13.3% $15,001 $15,943 6.3% $9,328 $9,212 -1.2% $39,318 $42,141 7.2%
West Virginia                        
Medicaid $252 $543 115.5% $211 $243 15.2% $2,100 $1,978 -5.8% $2,563 $2,764 7.2%
Non-Medicaid $3,452 $3,601 4.3% $11,911 $13,297 11.6% $2,375 $2,086 -12.2% $17,738 $18,984 7.2%
Total $3,704 $4,144 11.9% $12,122 $13,540 11.7% $4,475 $4,064 -9.2% $20,301 $21,748 7.2%
SLC Average                        
Medicaid $1,502 $2,343 57.4% $770 $1,056 150.1% $5,658 $5,405 -5.3% $7,930 $8,803 8.8%
Non-Medicaid $9,989 $10,401 5.1% $8,378 $8,715 7.3% $7,674 $6,301 -13.0% $26,041 $25,418 -0.6%
Total $11,491 $12,744 10.9% $9,148 $9,771 8.9% $13,332 $11,706 -10.4% $33,971 $34,221 1.5%

Notes:

Non-Medicaid includes expenditures for elementary and secondary education, higher education, public assistance, corrections, transportation, and all other non-capital expenditures. Specifics for each state are included in the NASBO reports. All funds exclude bonds.

* Notes in 2010-2012 Report (p.49)

** Notes in 2011-2013 Report (p.49)

*** Notes in both reports

Sources:

NASBO FY 2010-2012 State Expenditure Report

NASBO FY 2011-2013 State Expenditure Report