State Medicaid Spending, SFY2008 - Kaiser State Health Facts

Data are for state fiscal year 2008 (SFY2008) and include the General Fund and Other State Fund expenditures.

In 46 states the fiscal year begins on July 1 and ends on June 30. The exceptions are as follows: in Alabama and Michigan the fiscal year begins on October 1; in Texas, the fiscal year begins on September 1; and in New York, the fiscal year begins on April 1. Additionally, the length of budget cycles vary among states, with more than half of the states budgeting annually and the remainder enacting biennial budgets.

The state and federal Medicaid spending data posted on statehealthfacts.org are for different years, come from different sources, and cannot be used to calculate Total Medicaid spending.

Sources:

Table 28, Medicaid Expenditures, 2008 State Expenditure Report, National Association of State Budget Officers, 2009. Available at http://www.nasbo.org/Publications/StateExpenditureReport/tabid/79/Default.aspx.

Definitions:

NA: Data not available.
General Fund: the predominant fund for financing a states operations. Revenues are received from broad-based state taxes. There are differences in how specific functions are financed from state to state, however. General Funds include funds appropriated to the Medicaid agency and any other agency, which are used for direct Medicaid matching purposes under Title XIX.
Federal Funds: Funds received directly from the federal government.
Other State Fund: expenditures from revenue sources, which are restricted by law for particular governmental functions or activities. Other State Funds include funds and revenue sources used as Medicaid match, such as local funds and provider taxes, fees, donations, and assessments. These figures do not capture 100 percent of state provider taxes, fees, donations, assessments and local funds.

State Fiscal Year: The State Fiscal Year (SFY) begins on July 1 and ends on June 30 in 46 states; however, in Alabama and Michigan, the fiscal year begins on October 1; in Texas, the fiscal year begins on September 1; and in New York, the fiscal year begins on April 1. For example, in the 46 states following the July to June definition, SFY 2009 would refer to the period from July 1, 2008 through June 30, 2009.

Footnotes:

1. Includes $59 million in provider taxes.

2. Medicaid totals are adjusted for the ARRA impact on federal funds.

3. Medicaid Appropriation is "gross funded"- Federal funds are deposited directly to the State Treasury. Connecticut's FMAP is currently at 50 percent of Medicaid benefit costs (excluding enhanced FMAP available under ARRA). Excludes state portion of Qualified Medicare Beneficiaries and School Based Child Health as those expenditures are netted out of federal Medicaid reimbursement.

4. Changes to reporting of fiscal 2008 data include prior year state fund reserves being classifed as state funds (previously other funds). Previous surveys included adjustments to represent information on an accrual basis. These adjustments have been excluded in fiscal 2008. Other funds for fiscal 2008 include provider fees (nursing home, care management organization, and ambulance) and local funds.

5. Other State Funds include $106.7 million in tobacco settlement funds, $65 million in HMO/MCO tax, $25.8 million in nursing facility assessments, $13.6 million in local repayments of audit disallowance, $5 million in other local funds, and $0.9 million in interest from the Community Services Trust Fund.

6. Other State Funds include local funds of $101 million and provider taxes of $1,022 million.

7. Public health and community and institutional care for mentally and developmentally disabled persons are partially reported in the Medicaid totals.

8. Medicaid data is from the CMS 64 Report used for federal reporting of Medicaid expenditures. The split between the General Revenue Fund and Other Funds is an estimate. Medicaid does not track the General Revenue Fund versus Other State Fund in its reporting.

9. Other Funds include an estimated $601 million of local funds used to match Title XIX.

10. Medicaid spending does not include administrative costs or local government shares.

11. Regarding premium revenue: fiscal 2008 totals $68 million. Regarding Certified Public Expenditures- Local fund from hospitals: fiscal 2008 totals $325 million. Regarding Nursing Home Tax: fiscal 2008 totals $55 million. Regarding ICF/MR 6% Gross Receipts Tax: fiscal 2008 totals $12 million. Regarding Intergovermental Transfers: fiscal 2008 totals $0 million.

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