Medicaid enrollment fell in fiscal 2018 for the first time in over a decade, the Kaiser Family Foundation reported Thursday. File Photo by Tareq Salahuddin/UPI
Oct. 25 (UPI) -- Medicaid enrollment this year fell for the first time in more than a decade, which might be a sign of a healthy economy where fewer people need help paying medical expenses, the Kaiser Family Foundation reported Thursday.
The analysis said the rising cost of prescription drugs and premiums are still driving up the cost of medical insurance, and the upcoming midterm elections could have a dramatic effect on Medicaid's future.
Enrollment fell 0.6 percent in the 2018 fiscal year, KFF said, and states have raised their budget for Medicaid by 0.9 percent for the 2019 fiscal year. Enrollment peaked in 2015, but has declined since as enrollment in the Affordable Care Act also dropped off. Kaiser reported 27 states had enrollment declines this year.
The last time Medicaid enrollment fell was 2007.
"A stronger economy was a primary factor driving lower Medicaid enrollment growth and relatively steady spending growth as states finished state fiscal year 2018 and adopted budget for FY 2019," the foundation said. "The outcomes of the federal elections could determine whether Congress takes up legislation to make further changes to the ACA or to reform and cap Medicaid financing."
There are gubernatorial races in 36 states, while Idaho, Nebraska and Utah have ballot initiatives to expand ACA Medicaid.
Combined federal and state spending increased by 4.2 percent in 2018 and states expect a 5.3 percent increase for 2019, the Kaiser report said.
"The gap between enrollment and spending growth in part reflects lower enrollment growth for children and adults, who are relatively inexpensive to cover, compared to seniors and people with disabilities, who have more expensive needs."
President Donald Trump has encouraged states to "add work requirements to Medicaid that are likely to result in enrollment declines."
Unemployment fell two-tenths of a percentage point to 3.7 percent in September, the lowest level in 50 years, and average hourly earnings fell 2.8 percent from September 2017.