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National Medicaid enrollment is expected to decline nearly 9% in fiscal year 2024 as state Medicaid agencies continue to unwind pandemic-related continuous enrollment protections. After record high enrollment, these estimates — courtesy of KFF's 23rd annual survey of state Medicaid directors — reflect a dramatic year-over-year decline in program enrollment from that previous high.
Driven by anticipated changes in enrollment, total Medicaid spending growth (federal and state spending combined) is expected to slow in FY 2024 to 3.4%; however, the state (non-federal) share of Medicaid spending is expected to increase by 17.2% in FY 2024 primarily due to phasing out enhanced federal Medicaid matching funds that are set to expire Dec. 31.
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