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Medicaid commissioner outlines FY26 request, explains large difference driven by lost COVID carryforward not just program growth
Summary
Medicaid Commissioner detailed enrollment changes since the pandemic, explained why FY26 appropriation needs rise after reduced carryforward, and provided program breakdowns by beneficiary group and projected FY26 funding needs.
Commissioner Jane Azar of the Alabama Medicaid Agency briefed the Joint Interim Committees on enrollment trends, federal COVID-era funding impacts and the department’s FY26 funding request, emphasizing that a one-time drop in carryforward funds—not a sudden surge in recipients—accounts for most of the requested increase.
"The 2026 budget request before you today is $1,237,000,000 in projected funding need," Azar explained, and then clarified that an estimated $53,000,000 in carryforward reduces the FY26 appropriation request to $1,184,000,000. She emphasized the $229,000,000 difference from the FY25 appropriation is largely explained by the loss of substantial COVID-era carryforward dollars.
Why it matters: Medicaid accounts for a large share of state health spending…
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