Runaway Medicaid Spending: A Threat to Health Care for the Poor?
About This Event

Medicaid accounted for 14.8 percent of the $2.1 trillion in total health spending in 2006 and 7 percent of the federal budget in 2007. In the next ten years, Medicaid expenditures are projected to grow at a rate of 7.9 percent per year, a rate that exceeds the growth of Listen to Audio


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other health care spending and the expected growth in the economy. These are some of the alarming facts reported in the first actuarial report on the financial outlook for Medicaid recently completed by the Office of the Actuary of the Centers for Medicare & Medicaid Services (CMS).

Even though Medicaid takes a back seat to Social Security and Medicare in most discussions of entitlement reform and financing, as this report points out, it is the largest source of general revenue spending for health care for both the federal and state governments. Because of this, the rapid growth in Medicaid spending in future years will present a major challenge for state and federal officials.

Why is Medicaid spending expected to grow faster than other health spending? This and other questions about the future of the program will be addressed at this event by CMS chief actuary Richard Foster; Christopher Truffer, the principal author of the 2008 Actuarial Report on the Financial Outlook for Medicaid; and CMS acting administrator Kerry Weems. John Holahan, a Medicaid expert and the director of the Urban Institute's Health Policy Center, will discuss the report's findings. AEI's Robert B. Helms will moderate.

Agenda
12:00 p.m.
Registration and Lunch
12:30
Presenters:
Richard Foster, Centers for Medicare & Medicaid Services
Christopher Truffer, Centers for Medicare & Medicaid Services
Kerry Weems, Centers for Medicare & Medicaid Services
Discussant:
John Holahan, Urban Institute
Moderator:
2:30

Adjournment

Event Summary

 

Financial Outlook for Medicaid: Spending to Continue to Outpace GDP Growth

 

 

WASHINGTON, NOVEMBER 12, 2008--For the first time ever, the Office of the Actuary for the Centers of Medicare and Medicaid Services (CMS) has produced an actuarial report on the financial outlook for Medicaid. Richard Foster, the chief actuary at CMS, and Christopher Truffer, the report's lead author, as well as CMS acting administrator Kerry Weems and John Holahan of the Urban Institute, discussed the report's findings at AEI on November 7.

One disturbing trend highlighted by the report is that Medicaid spending growth is outpacing and will continue to outpace the growth of the economy. Such excess growth has worrisome implications for both the federal budget (which currently finances 57 percent of Medicaid expenditures) and state budgets (which finance the remaining 43 percent). Medicaid has consumed an increasing portion of state budgets, supplanting spending in other areas such as education, law enforcement, and transportation. As Foster stressed, there is reason to be concerned that continued growth in federal spending on Medicaid may cause losses in state autonomy, since federal money received by states tends to come with "strings attached." This growth in spending in excess of GDP is projected to continue over the next ten years if no policies are enacted to mitigate it.

Panelists commented that there are two main drivers of the growth in Medicaid spending: the growth in the number of enrollees and the growth in spending per enrollee. Policies aimed at cost containment will differ depending on which of these is the primary cause of spending growth. Holahan suggested that although both issues will be important to address, growth in the number of enrollees will be a more significant driver of cost growth than growth in spending per enrollee in the short term because of the current economic downturn. He showed that from 2000 to 2002, a period coinciding with the most recent recession, the number of families enrolled in Medicare surged 11 percent and Medicaid spending on health services jumped 12.9 percent. But there is reason to believe that a large portion of this jump in total spending was due to a rise in prescription drug expenditures now covered under Medicare Part D. Changes in Medicare spending can have a significant effect on Medicaid spending. The Medicare Part D program may provide a silver lining for states as they figure out how to deal with the growing Medicaid burden.

--WALTON DUMAS

For video, audio, and event information, visit www.aei.org/event1832/.

For media inquiries, contact Veronique Rodman at 202.862.4870 or vrodman@aei.org.

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AEI Participants

 

Robert B.
Helms
  • Robert B. Helms has served as a member of the Medicaid Commission as well as assistant secretary for planning and evaluation and deputy assistant secretary for health policy at the U.S. Department of Health and Human Services (HHS). An economist by training, he has written and lectured extensively on health policy and health economics, including the history of Medicare, the tax treatment of health insurance, and compared international health systems. He currently participates in the Health Policy Consensus Group, an informal task force that is developing consumer-driven health reforms. He is the author or editor of several AEI books on health policy, including Medicare in the Twenty-First Century: Seeking Fair and Efficient Reform and Competitive Strategies in the Pharmaceutical Industry.
  • Phone: 2028625877
    Email: rhelms@aei.org
  • Assistant Info

    Name: Catherine Griffin
    Phone: 2028625920
    Email: catherine.griffin@aei.org
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