During the pandemic, the federal government has been providing an enhanced federal match for Medicaid. Typically, the federal government pays for 50% of Medicaid spending in Washington, and the state covers the other half. (A higher match is in place for some Medicaid clients, pursuant to the Affordable Care Act.) The enhanced pandemic federal medical assistance percentage (FMAP) is 6.2% (retroactive to Jan. 2020). In exchange for the enhanced FMAP, states have not been allowed to remove people from Medicaid. As I wrote last month, states are now allowed to disenroll people who are no longer eligible, and the enhanced FMAP will expire at the end of December.

The Kaiser Family Foundation (KFF) estimates that from Jan. 2020 through March 2023, Washington received $2.743 billion in federal funding due to the enhanced FMAP. This federal money supplanted state funds (though the continuous enrollment requirement may have also increased state Medicaid costs), so the state was able to use the savings to fund other programs and services. By my count, state operating budgets have assumed savings to funds subject to the outlook of $1.905 billion from the enhanced FMAP.

According to KFF, “While states received substantial enhanced federal funding of $117 billion during the continuous enrollment period, they will likely see increases in state Medicaid spending as the enhanced federal matching funds expire at the end of the year.”