Lawmakers hear overview of Medicaid budget as costs, forecasts and supplementals rise

The Joint Finance-Appropriations Committee on Feb. 26 reviewed the Department of Health and Welfare’s requested supplementals and 2026 budget enhancements for the Division of Medicaid as spending pressures persist.

Analyst Alex Williamson of the legislative services office told the committee the division expended about $4.27 billion of the roughly $4.56 billion appropriated in fiscal year 2024 and outlined five Medicaid benefit programs that drive state spending, including the expansion population that went live in January 2020.

Why this matters: Medicaid is an entitlement program with a mix of state and federal financing; changes in caseload, provider rates, federal matching (FMAP) and one‑time adjustments have produced large year‑over‑year swings. Committee members pressed the department on forecast methods and on whether the governor’s recommendation included programmatic cost containment.

Williamson said the expansion population and other…