Another Risk Point for the State’s 10-11 Budget? Counts of NH families with Children on Medicaid have grown at 8% per year between May of 2008 and May of 2009. During the previous year, these caseloads increased not at all. What will happen to Medicaid caseloads going forward and what implications are there for the 2010-2011 Medicaid budget?
For reasons of population growth, federal and state policy, and economic change, Medicaid caseloads have grown considerably over the last 30 years. In 1981, slightly less than 10,000 families with children were enrolled in Medicaid in New Hampshire. In 2009, over 40,000 were enrolled. This increase of almost 6% per year has been consistent with growth in caseloads across the country.
Figure 1: Growth in Medicaid Cases (1981-2009)
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Caseloads have been growing more quickly recent. Between May of 2008 and May of 2009 (the last month for which data is available), Medicaid caseloads increased by 8.0%. This represented an increase of slightly more than 9,000 Medicaid clients. What can we expect for the next year? In the 2010-2011 budget development process, much attention was paid to how Medicaid caseloads were going to grow. In the end, the budget included growth rates of a little more than 1%. If caseloads were to increase by another 9,000 clients, and the average client cost $2,500, the 2010-11 budget could be short as much as $20 million in total funds (or $10 million in general funds).
How caseloads will ultimately grow is a function of what happens with the state’s economy as has been documented elsewhere. During the same time period in which Medicaid caseloads grew at 8%, the unemployment rate increased by 88% from 3.4 to 6.4, with most of that increase occurring between October of 2008 and May of 2009. The New England Economic Partnership (NEEP) has projected the loss of another 14,000 jobs before an economic recovery begins. If NEEP is right, we will see Medicaid caseload growth abate considerably. But is NEEP right about where the economy is headed?
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