As of August 1, 2024, approximately 2.5 million Medicaid enrollees have been disenrolled in Texas, the highest number of people disenrolled across all states in the United States. Overall, more than 24.5 million people in the United States have lost their Medicaid coverage, the majority of those terminations were for so-called procedural reasons, which means that the enrollees did not finish the renewal process for various reasons.

This dataset contains aggregate Medicaid payments, and counts for eligible recipients and recipients served by month and county in Iowa, starting with month ending 1/31/2011.

Eligibility groups are a category of people who meet certain common eligibility requirements. Some Medicaid eligibility groups cover additional services, such as nursing facility care and care received in the home. Others have higher income and resource limits, charge a premium, only pay the Medicare premium or cover only expenses also paid by Medicare, or require the recipient to pay a specific dollar amount of their medical expenses. Eligible Medicaid recipients may be considered medically needy if their medical costs are so high that they use up most of their income. Those considered medically needy are responsible for paying some of their medical expenses. This is called meeting a spend down. Then Medicaid would start to pay for the rest. Think of the spend down like a deductible that people pay as part of a private insurance plan.

The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each major eligibility group over the year (duplicated count); (2) the number of beneficiaries enrolled in each major eligibility group as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment in each major eligibility group.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topic Eligibility Group Code. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

Children accounted for 36.5 percent of Medicaid enrollees in 2021, which was the largest share of all enrollment groups. The elderly and persons with disabilities had the smallest shares, but together they accounted for more than half of all Medicaid expenditure.

Medicaid expenditures per enrollee Medicaid is a joint federal and state health care program in the United States. The program provides medical coverage to millions of Americans and supports a variety of enrollment groups, particularly senior citizens and individuals with disabilities. Medicaid per enrollee spending is significantly higher for these two groups because they require more frequent and costly long-term care in the community and nursing homes. In 2022 of the total U.S. health expenditure on home health care, Medicaid paid one-third.

Millions of Americans are uninsured The United States has a multi-payer health care system, meaning that some Americans will be covered by private health insurance, and others will be covered by a government program such as Medicaid. However, approximately 27.6 million people in the U.S. had no health insurance in 2021, and should they require health care, they would have to pay the full price out of their own pocket. This becomes a real problem for many because the United States has the most expensive health care system in the world.

Archived as of 6/26/2025: The datasets will no longer receive updates but the historical data will continue to be available for download. This dataset provides information related to the claims of recipients enrolled in Medicaid. It contains information about the total number of patients, total number of claims, and total dollar amount, grouped by recipient race and gender. Restricted to claims with service date between 01/2012 to 12/2017. Restricted to patients with a Medicaid claim during this period. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Total Medicaid Enrollees represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and Medicare-Medicaid ("dual") enrollees. Total Medicaid enrollment in Any Type of Managed Care represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, and PCCMs. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), or PACE program. It excludes beneficiaries who are enrolled in a Financial Alignment Demonstration Medicare-Medicaid Plan as their only form of managed care. The “Medicaid Enrollment in Comprehensive MCOs Under ACA Section VIII Expansion” column is a subset of the total reported in column C and includes individuals who are enrolled in comprehensive MCOs and are low-income adults, with or without dependent children, eligible for Medicaid under ACA Section VIII. n/a" indicates that a state or territory was either not able to report data or does not operate a managed care program.

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts.

1. Total Medicaid Enrollees represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and Medicare-Medicaid ("dual") enrollees.
2. Total Medicaid enrollment in Any Type of Managed Care represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, and PCCMs.
3. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), or PACE program. It excludes beneficiaries who are enrolled in a Financial Alignment Demonstration Medicare-Medicaid Plan as their only form of managed care.
4. The “Medicaid Enrollment in Comprehensive MCOs Under ACA Section VIII Expansion” column is a subset of the total reported in column C and includes individuals who are enrolled in comprehensive MCOs and are low-income adults, with or without dependent children, eligible for Medicaid under ACA Section VIII.
5. n/a" indicates that a state or territory was either not able to report data or does not operate a managed care program.

The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data.

1. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program.

2. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing.

3. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities.

4. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.

This data set includes monthly counts and rates (per 1,000 beneficiaries) of behavioral health services, including emergency department services, inpatient services, intensive outpatient/partial hospitalizations, outpatient services, or services delivered through telehealth, provided to Medicaid and CHIP beneficiaries, by state. Users can filter by either mental health disorder or substance use disorder. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating behavioral health services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Claims Volume - IP, Claims Volume - OT, Diagnosis Code - IP, Diagnosis Code - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by program type (Medicaid or CHIP). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each program type over the year (duplicated count); (2) the number of beneficiaries enrolled in each program type as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment in each program type.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Medicaid-only enrollment and M-CHIP and S-CHIP Enrollment. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This profile shows a detailed summary of recipients, units of service, paid claim dollars, dollars per individual and dollars per units of service for services reimbursed by Medicaid Fee for Service billing as well as Medicaid Managed Care Plans for chemical dependence and non-chemical dependence services received per state fiscal year (SFY).

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by benefit package (full-scope, comprehensive, limited, or unknown). There are three metrics presented: (1) the number of beneficiaries ever enrolled with each benefit package over the year (duplicated count); (2) the number of beneficiaries enrolled with each benefit package as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment with each benefit package. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Restricted Benefits Code. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.