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Medicaid Enrollment Is Back Near 2019 Levels, but Inflation-Adjusted Federal Spending Is 35 Percent Higher

1Nk Medicaid Enrollment Is Back Near 2019 A0Wuu0000069S5Myaa
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Brian Blase
President at Paragon Health Institute

Brian Blase, Ph.D., is the President of Paragon Health Institute. Brian was Special Assistant to the President for Economic Policy at the White House’s National Economic Council (NEC) from 2017-2019, where he coordinated the development and execution of numerous health policies and advised the President, NEC director, and senior officials. After leaving the White House, Brian founded Blase Policy Strategies and served as its CEO.

This Paragon Pic shows the contrast between Medicaid enrollment and federal Medicaid spending from 2019 to 2026 is striking. Medicaid enrollment rose sharply during the pandemic, peaked in 2023, and subsequently fell as eligibility redeterminations resumed. By 2026, average monthly enrollment was approaching its 2019 level. Yet inflation-adjusted federal Medicaid spending remained approximately 35 percent above 2019 levels. The divergence between enrollment and spending underscores how Medicaid financing increasingly benefits large hospital systems and insurers rather than the vulnerable populations the program was designed to serve.

1Nk Medicaid Enrollment Is Back Near 2019 A0Wuu0000069S5Myaa

This Paragon Pic shows the contrast between Medicaid enrollment and federal Medicaid spending from 2019 to 2026 is striking. Medicaid enrollment rose sharply during the pandemic, peaked in 2023, and subsequently fell as eligibility redeterminations resumed. By 2026, average monthly enrollment was approaching its 2019 level. Yet inflation-adjusted federal Medicaid spending remained approximately 35 percent above 2019 levels. The divergence between enrollment and spending underscores how Medicaid financing increasingly benefits large hospital systems and insurers rather than the vulnerable populations the program was designed to serve.

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Brian Blase
President at Paragon Health Institute

Brian Blase, Ph.D., is the President of Paragon Health Institute. Brian was Special Assistant to the President for Economic Policy at the White House’s National Economic Council (NEC) from 2017-2019, where he coordinated the development and execution of numerous health policies and advised the President, NEC director, and senior officials. After leaving the White House, Brian founded Blase Policy Strategies and served as its CEO.