From fiscal year (FY) 2000 to FY 2010, Medicaid expenditures in Alabama increased at a rate of 6.7% per year, and combined state and federal total expenditures rose from $2.85 billion to $4.75 billion. Instead of slowing, the cost of Medicaid will likely accelerate as new federal policies that are part of the Patient Protection and Affordable Care Act of 2010 (PPACA) are implemented. Since 2000, total Medicaid enrollment in Alabama has increased by 41%, from 676,938 persons in FY 2000 to 954,793 in FY 2009. With no limits on the amount of money the federal government will provide as a match to state Medicaid expenditures, total Medicaid expenditures and its overall share of the federal budget are expected to rise from 1.9% of the nation’s gross domestic product in 2010 to 4.5% in 2050.

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