by Adrianna McIntyre -
The latest in “drives Adrianna bonkers” is the unrelenting prediction about the federal government withdrawing Medicaid funding after states decide to expand. Intuitively, I understand where the concerns come from. But what do data and history have to say on the matter?
Turns out that since Medicaid was passed in 1965, average funding levels have remained flat—and haven’t oscillated outside the 55-59% range since 1980 (with a brief bump during the recession being one exception—more on that in a moment).
Data from the graph below was pulled from this 2012 report to Congress (p22).
Yes, there’s a blip there between 2009 and 2012, I see it. That’s because the American Recovery and Reinvestment Act—which you probably know better as “the stimulus package”—was passed in February 2009 and included a deliberate and temporary boost to Medicaid funding to help states buffer against the recession. It was never meant to be a permanent increase to Medicaid federal match rates; I don’t consider it sound logic to hold temporary policy against baseline estimates. That increase was phased back down to a baseline level of 57%.
I get that the 2014 funding bump is big. The bump was big in 1965, too, and the feds haven’t backed down yet.
(and a great many thanks to Karan for putting the graph together)