Enrollment is one driving factor in Medicaid cost growth. During the period from June 2001 to June 2010, Medicaid enrollment grew 47 percent nationally, 69 percent in Michigan, and an average of 66 percent in the Great Lake states (excluding Michigan; includes Illinois, Indiana, Minnesota, Ohio, Pennsylvania, and Wisconsin). Most of this growth can be explained by two nationwide recessions (one long recession in Michigan), and the recessions’ impact on income levels and access to other forms of health care. During this time, national year-over-year enrollment grew with the exception of 2007 where enrollment fell by 0.6 percent compared to 2006. Not surprisingly, enrollments also increased rapidly during the 2001 recession and the Great Recession ending in 2009. Total Medicaid enrollment reached a record high in June 2010 of 50.3 million.
Chart 1. Total Medicaid Enrollment, Percent Growth from June 2001 through June 2010
Michigan compared to US Average and Great Lake States Average
Source: The Kaiser Commission on Medicaid and the Uninsured. Medicaid Enrollment: June 2010 Data Snapshot. The Kaiser Family Foundation: Publication #8050-03. January 2011.
In January 2012, there were 1.92 million Medicaid recipients in Michigan, which translates to 19.4 percent of the population, up from 18 percent in fiscal year 2007. Forty percent of the Medicaid recipients were enrolled in family Medicaid, 35 percent were pregnant women and children under age 19 and the remaining 25 percent were aged, blind or disabled. Between June 2001 and June 2010, Medicaid enrollment grew faster in Michigan and the Great Lake states compared to the nationwide average. Medicaid enrollment growth in Michigan peaked between June 2009 and June 2010 at 11 percent, compared with a nationwide average growth of 7.2 percent.
Table 1 shows Michigan Medicaid recipients by county as of January 2012. The five counties with the highest and those with the lowest Medicaid enrollment are included. Enrollment was highest in Oceana County with 28.1 percent of its population enrolled, whereas Livingston County had the lowest rate of enrollment at 8.8 percent of population. The state’s largest county, Wayne, was ranked third with 27.6 percent of the population enrolled in Medicaid, and had the largest number of recipients at 502,270. The median Michigan county enrollment was 19.8 percent.
Table 1. Total Medicaid Recipients in Michigan by County, June 2011
Sources: Green Book Report of Key Program Statistics, January 2012. Michigan Department of Human Services
Population Data from the Michigan Department of Treasury
Note: Population data is from 2009, the most recent available.