Policy Analysis | August 2014
Southern States' Medicaid Spending
Between FY 2010 and FY 2012, Medicaid expenditures outgrew other areas of state budgets by a large margin in most of the SLC states. In FY 2012, state general fund Medicaid expenditures were an average of 57.4 percent higher in the SLC states than in FY 2010. During this same period, non-Medicaid expenditures only increased by an average of 5.1 percent. Non-Medicaid expenditures include elementary and secondary education, higher education, public assistance, corrections, transportation, and all other non-capital expenditures.
It should be noted, however, that during these fiscal years many states exhausted the use of federal ARRA funds and returned to a lower federal matching rate for Medicaid. During the preceding budget years while states were experiencing reduced revenues, many states used ARRA funds to supplant state funds in order to maintain their level of service; upon exhaustion of the ARRA funds, state funds were necessary to refill these budget holes.
The data for these calculations comes from the National Association of State Budget Officers (NASBO) FY2010-2012 State Expenditure Report and FY 2011-2013 State Expenditure Report. Classification of funds is not uniform across the states; explanations of notable differences are available in the NASBO reports.
SLC Member States' Medicaid and Non-Medicaid Spending, FY 2010-12
| General State Funds | Other State Funds | Federal Funds | Total Funds | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| State Expenditures ($ in millions) | FY 2010 | FY 2012 | % Change from FY10 | FY 2010 | FY 2012 | % Change from FY10 | FY 2010 | FY 2012 | % Change from FY10 | FY 2010 | FY 2012 | % Change from FY10 |
| Alabama | ||||||||||||
| Medicaid *** | $315 | $575 | 82.5% | $1,122 | $1,257 | 12.0% | $3,957 | $3,795 | -4.1% | $5,394 | $5,627 | 4.3% |
| Non-Medicaid | $6,273 | $6,699 | 6.8% | $3,841 | $6,013 | 56.5% | $4,705 | $5,513 | 17.2% | $14,819 | $18,225 | 23.0% |
| Total | $6,588 | $7,274 | 10.4% | $4,963 | $7,270 | 46.5% | $8,662 | $9,308 | 7.5% | $20,213 | $23,852 | 18.0% |
| Arkansas | ||||||||||||
| Medicaid | $602 | $630 | 4.7% | $179 | $652 | 264.2% | $3,209 | $3,142 | -2.1% | $3,990 | $4,424 | 10.9% |
| Non-Medicaid | $3,621 | $3,952 | 9.1% | $8,537 | $9,041 | 5.9% | $3,685 | $3,136 | -14.9% | $15,843 | $16,129 | 1.8% |
| Total | $4,223 | $4,582 | 8.5% | $8,716 | $9,693 | 11.2% | $6,894 | $6,278 | -8.9% | $19,833 | $20,553 | 3.6% |
| Florida | ||||||||||||
| Medicaid * | $2,564 | $4,010 | 56.4% | $3,166 | $4,330 | 36.8% | $12,189 | $10,929 | -10.3% | $17,919 | $19,269 | 7.5% |
| Non-Medicaid | $18,652 | $19,043 | 2.1% | $7,446 | $8,598 | 15.5% | $16,769 | $13,686 | -18.4% | $42,867 | $41,327 | -3.6% |
| Total | $21,216 | $23,053 | 8.7% | $10,612 | $12,928 | 21.8% | $28,958 | $24,615 | -15.0% | $60,786 | $60,596 | -0.3% |
| Georgia | ||||||||||||
| Medicaid | $1,663 | $2,641 | 58.8% | $389 | $605 | 55.5% | $5,832 | $5,599 | -4.0% | $7,884 | $8,845 | 12.2% |
| Non-Medicaid | $12,898 | $14,599 | 13.2% | $9,992 | $10,181 | 1.9% | $8,809 | $6,870 | -22.0% | $31,699 | $31,650 | -0.2% |
| Total | $14,561 | $17,240 | 18.4% | $10,381 | $10,786 | 3.9% | $14,641 | $12,469 | -14.8% | $39,583 | $40,495 | 2.3% |
| Kentucky | ||||||||||||
| Medicaid | $811 | $1,319 | 62.6% | $383 | $373 | -2.6% | $4,499 | $4,090 | -9.1% | $5,693 | $5,782 | 1.6% |
| Non-Medicaid | $7,639 | $8,015 | 4.9% | $6,631 | $7,255 | 9.4% | $5,978 | $4,597 | -23.1% | $20,248 | $19,867 | -1.9% |
| Total | $8,450 | $9,334 | 10.5% | $7,014 | $7,628 | 8.8% | $10,477 | $8,687 | -17.1% | $25,941 | $25,649 | -1.1% |
| Louisiana | ||||||||||||
| Medicaid | $722 | $1,770 | 145.2% | $479 | $598 | 24.8% | $5,634 | $4,863 | -13.7% | $6,835 | $7,231 | 5.8% |
| Non-Medicaid | $8,094 | $6,574 | -18.8% | $9,889 | $7,195 | -27.2% | $6,225 | $5,753 | -7.6% | $24,208 | $19,522 | -19.4% |
| Total | $8,816 | $8,344 | -5.4% | $10,368 | $7,793 | -24.8% | $11,859 | $10,616 | -10.5% | $31,043 | $26,753 | -13.8% |
| Mississippi | ||||||||||||
| Medicaid ** | $139 | $73 | -47.5% | $849 | $1,050 | 23.7% | $3,199 | $3,182 | -0.5% | $4,187 | $4,305 | 2.8% |
| Non-Medicaid | $4,315 | $4,422 | 2.5% | $4,927 | $4,543 | -7.8% | $8,910 | $4,763 | -46.5% | $18,152 | $13,728 | -24.4% |
| Total | $4,454 | $4,495 | 0.9% | $5,776 | $5,593 | -3.2% | $12,109 | $7,945 | -34.4% | $22,339 | $18,033 | -19.3% |
| Missouri | ||||||||||||
| Medicaid *** | $1,422 | $1,719 | 20.9% | $1,921 | $2,224 | 15.8% | $4,019 | $4,245 | 5.6% | $7,362 | $8,188 | 11.2% |
| Non-Medicaid | $6,143 | $6,219 | 1.2% | $4,449 | $5,663 | 27.3% | $4,724 | $3,294 | -30.3% | $15,316 | $15,176 | -0.9% |
| Total | $7,565 | $7,938 | 4.9% | $6,370 | $7,887 | 23.8% | $8,743 | $7,539 | -13.8% | $22,678 | $23,364 | 3.0% |
| North Carolina | ||||||||||||
| Medicaid | $2,319 | $3,517 | 51.7% | $1,364 | $468 | -65.7% | $8,113 | $7,535 | -7.1% | $11,796 | $11,520 | -2.3% |
| Non-Medicaid | $16,194 | $16,678 | 3.0% | $11,219 | $10,739 | -4.3% | $9,050 | $6,978 | -22.9% | $36,463 | $34,395 | -5.7% |
| Total | $18,513 | $20,195 | 9.1% | $12,583 | $11,207 | -10.9% | $17,163 | $14,513 | -15.4% | $48,259 | $45,915 | -4.9% |
| Oklahoma | ||||||||||||
| Medicaid | $550 | $1,225 | 122.7% | $617 | $1,093 | 77.1% | $3,141 | $2,686 | -14.5% | $4,308 | $5,004 | 16.2% |
| Non-Medicaid | $4,205 | $5,268 | 25.3% | $5,587 | $6,481 | 16.0% | $6,215 | $4,032 | -35.1% | $16,007 | $15,781 | -1.4% |
| Total | $4,755 | $6,493 | 36.6% | $6,204 | $7,574 | 22.1% | $9,356 | $6,718 | -28.2% | $20,315 | $20,785 | 2.3% |
| South Carolina | ||||||||||||
| Medicaid ** | $529 | $640 | 21.0% | $546 | $719 | 31.7% | $3,521 | $3,426 | -2.7% | $4,596 | $4,785 | 4.1% |
| Non-Medicaid | $4,617 | $4,877 | 5.6% | $6,233 | $6,445 | 3.4% | $4,170 | $5,858 | 40.5% | $15,020 | $17,180 | 14.4% |
| Total | $5,146 | $5,517 | 7.2% | $6,779 | $7,164 | 5.7% | $7,691 | $9,284 | 20.7% | $19,616 | $21,965 | 12.0% |
| Tennessee | ||||||||||||
| Medicaid *** | $1,632 | $2,792 | 71.1% | $322 | $534 | 65.8% | $6,227 | $6,007 | -3.5% | $8,181 | $9,333 | 14.1% |
| Non-Medicaid | $8,282 | $8,893 | 7.4% | $5,162 | $5,140 | -0.4% | $6,724 | $6,799 | 1.1% | $20,168 | $20,832 | 3.3% |
| Total | $9,914 | $11,685 | 17.9% | $5,484 | $5,674 | 3.5% | $12,951 | $12,806 | -1.1% | $28,349 | $30,165 | 6.4% |
| Texas | ||||||||||||
| Medicaid * | $6,420 | $10,115 | 57.6% | $0 | $1,697 | 1697.0% | $15,269 | $16,126 | 5.6% | $21,689 | $27,938 | 28.8% |
| Non-Medicaid | $33,054 | $33,759 | 2.1% | $14,845 | $14,195 | -4.4% | $21,404 | $15,410 | -28.0% | $69,303 | $63,364 | -8.6% |
| Total | $39,474 | $43,874 | 11.1% | $14,845 | $15,892 | 7.1% | $36,673 | $31,536 | -14.0% | $90,992 | $91,302 | 0.3% |
| Virginia | ||||||||||||
| Medicaid | $2,590 | $3,569 | 37.8% | $0 | $0 | 0.0% | $3,963 | $3,465 | -12.6% | $6,553 | $7,034 | 7.3% |
| Non-Medicaid | $12,399 | $13,417 | 8.2% | $15,001 | $15,943 | 6.3% | $5,365 | $5,747 | 7.1% | $32,765 | $35,107 | 7.1% |
| Total | $14,989 | $16,986 | 13.3% | $15,001 | $15,943 | 6.3% | $9,328 | $9,212 | -1.2% | $39,318 | $42,141 | 7.2% |
| West Virginia | ||||||||||||
| Medicaid | $252 | $543 | 115.5% | $211 | $243 | 15.2% | $2,100 | $1,978 | -5.8% | $2,563 | $2,764 | 7.2% |
| Non-Medicaid | $3,452 | $3,601 | 4.3% | $11,911 | $13,297 | 11.6% | $2,375 | $2,086 | -12.2% | $17,738 | $18,984 | 7.2% |
| Total | $3,704 | $4,144 | 11.9% | $12,122 | $13,540 | 11.7% | $4,475 | $4,064 | -9.2% | $20,301 | $21,748 | 7.2% |
| SLC Average | ||||||||||||
| Medicaid | $1,502 | $2,343 | 57.4% | $770 | $1,056 | 150.1% | $5,658 | $5,405 | -5.3% | $7,930 | $8,803 | 8.8% |
| Non-Medicaid | $9,989 | $10,401 | 5.1% | $8,378 | $8,715 | 7.3% | $7,674 | $6,301 | -13.0% | $26,041 | $25,418 | -0.6% |
| Total | $11,491 | $12,744 | 10.9% | $9,148 | $9,771 | 8.9% | $13,332 | $11,706 | -10.4% | $33,971 | $34,221 | 1.5% |
Notes:
Non-Medicaid includes expenditures for elementary and secondary education, higher education, public assistance, corrections, transportation, and all other non-capital expenditures. Specifics for each state are included in the NASBO reports. All funds exclude bonds.
* Notes in 2010-2012 Report (p.49)
** Notes in 2011-2013 Report (p.49)
*** Notes in both reports
Sources: