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Congress Should Provide States Flexibility to Manage Medicaid Enrollment Growth

Washington, D.C. — A new report released today by the Foundation for Government Accountability details the implications of skyrocketing Medicaid enrollment and its effects on increasing costs to maintain the program.

The Congressional Budget Office expects federal Medicaid spending to nearly double during the next decade, reaching $650 billion per year by 2027.

The American Health Care Act seeks to control spending through controlling growth in spending per person. However, enrollment is driving nearly 73% of spending growth, and FGA believes the impact of those caps will be small. Senator Pat Toomey (R-PA) has been a leader in the Senate in reforming the Medicaid program in a way that puts it on a sustainable path for the future.

States need new tools to deal with skyrocketing enrollment. The AHCA lays the groundwork with work requirements, but the Senate should take the next step and provide states with at least four additional reforms to give states flexibility to control Medicaid enrollment and protect limited resources for the truly needy:

  1. Allow states to make eligibility and benefit changes prospectively, grandfathering existing enrollees
  2. Allow states to check assets for most enrollees
  3. Allow states to verify eligibility more frequently
  4. Allow states to lower the home equity exemption

To read the report, click here. For a summarized version, click here.

The Foundation for Government Accountability is a non-profit, multi-state think tank that specializes in health care, welfare, and regulatory reform. To learn more, visit


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