Consistent with the national pattern, all five study states experienced a decline in Medicaid enrollment for children and adults during 1995, although the extent of the decline varied (Table 3). New Jersey’s Medicaid enrollment in December was only 0.8 percent below its January level, compared to a 4.2 difference in Florida by year end. The other three states had declines of 2.1 to 3.8 percent.
|Enrollment in Jan.1995|
|Enrollment in Dec.1995|
|Source: 1995 State Medicaid Research File data.|
The level of Medicaid decline attributable to reduced AFDC enrollment was fairly consistent with the level of decline reported by each state’s welfare program (shown in Table 1).(3) Helping offset the welfare declines in every state were increases in the poverty-related groups, although the extent of the increase varied. The increase in poverty-related coverage was only 3.2 percent in Alabama, but this lower rate occurred in part because the poverty-related group already accounted for nearly half the state’s Medicaid enrollees at the beginning of the year. At the other extreme, poverty-related coverage increased by almost 23 percent during 1995 in California, but it still accounted for only 2.4 percent of overall enrollment at year’s end. Michigan also had a high growth rate (23.4 percent) for poverty-related coverage during the year. By year’s end, the poverty-related groups accounted for 15.1 percent of Medicaid enrollment in Michigan. Alabama and Florida, which had the lowest AFDC benefit levels and no or marginal medically needy coverage among the study states, had the lowest rates of increase for poverty-related coverage, but they were making greater use of the poverty-related coverage at the start of 1995 than the other three states.
There were no clear changes in enrollment patterns across the states for persons covered under either the medically needy group or the residual “other” eligibility group. Michigan was the only state with growth in medically needy enrollment during 1995. Michigan and New Jersey reported sizable increases in enrollment under the other coverage group (27.8 percent and 17.8 percent, respectively). This residual coverage group includes families qualifying for transitional assistance. California’s 7.9 percent decrease in enrollment under the other coverage group occurred because of a decline during the year in the number of families affected under a class-action court decision.4
In all five states, the drop in adult Medicaid enrollment during 1995 was greater than that reported for children. This pattern was expected, since adults in all the states had fewer options for noncash coverage than children.