In fiscal year 2022, Medicaid spent 8,813 U.S. dollars per full-year equivalent enrollee. However, spending per enrollee varied by state with North Dakota spending the most per enrollee at 13,001 U.S. dollars, while in South Carolina each Medicaid enrollee cost 5,199 U.S. dollars. This statistic illustrates Medicaid benefit spending per full-year equivalent (FYE) enrollee in the United States in FY 2022, by state.

2023 saw the largest expenditures on Medicaid in U.S. history. At that time about 894 billion U.S. dollars were expended on the Medicaid public health insurance program that aims to provide affordable health care options to low income residents and people with disabilities. Medicaid was signed into law in 1965. By 1975 around 13 billion U.S. dollars were spent on the program. Groups covered by Medicaid There are several components of the Medicaid health insurance program. The Children’s Health Insurance Program (CHIP) was started in 1997 to provide health coverage to families and children that could not afford care. As of 2021, children represented the largest distribution of Medicaid enrollees. Despite having the largest proportion of enrollees, those that were enrolled in Medicaid as children had the lowest spending per enrollee. As of 2021, disabled Medicaid enrollees had the highest spending per enrollee. Medicaid expenditures Currently, Medicaid accounts for 19 percent of all health care expenditure in the United States. Expenditures on Medicaid programs vary among the U.S. states and depend heavily on whether Medicaid expansion was accepted after the Affordable Care Act was enacted. California and New York are the top states with the highest Medicaid expenditures. It is projected that Medicaid expenditure will continue to increase at both the state and federal levels.

In fiscal year 2022, Medicaid spent 8,813 U.S. dollars per full-year equivalent enrollee. However, spending per enrollee varied by eligibility group with disabled enrollees costing the most per enrollee at 25,483 U.S. dollars. States also show large variations in Medicaid spending per enrollee. This statistic illustrates Medicaid benefit spending per full-year equivalent (FYE) enrollee in the United States in FY 2022, by eligibility group.

In FY 2022, Medicaid expenditure on disabled persons was estimated to have totaled 234 billion U.S. dollars, which was more than any other enrollment group. Disabled individuals also had the highest per enrollee Medicaid costs during the year. The high costs of health care Federal and state governments together spent an estimated 640 billion U.S. dollars on the Medicaid health insurance program in 2019. Despite having the smallest shares of Medicaid enrollees, the elderly and disabled groups combined to account for more than half of all Medicaid expenditure in 2019. These two groups have a significantly higher per enrollee expenditure because they have greater long-term needs – Medicaid expenditure on acute care and long-term care benefits combined for approximately 260 billion U.S. dollars in 2017. Which eligibility group has the most enrollees? Elderly individuals can qualify for Medicaid through several pathways, but an income-based methodology is primarily used to determine eligibility for most adults, pregnant women, and children. Children accounted for 37.5 percent of Medicaid enrollees in 2019, which was the largest share of all enrollment groups. Around 28 million children are enrolled in Medicaid programs across the United States, and the number of enrollees is projected to top 30 million in the coming years.

In 2020, Medicaid spending per female enrollee amounted to ***** U.S. dollars, and for per male enrollee, it amounted to approximately eight thousand U.S. dollars. Medicaid per-person spending on males was higher than that on females during the provided time interval. This statistic displays Medicaid per enrollee spending in the U.S. from 2002 to 2020, by gender.

This dataset identifies health care spending at medical services such as hospitals, physicians, clinics, and nursing homes etc. as well as for medical products such as medicine, prescription glasses and hearing aids. This dataset pertains to Medicaid personal health care spending. Other datasets in this series include Medicare personal health care spending and personal health care spending in general.

Total Medicaid spending surpassed 804 billion U.S. dollars in 2022. The state of California had the highest expenditure throughout the year, followed by New York and Texas.

Federal government helps poorer states Both the federal and state governments fund the Medicaid health care program, but at least 50 percent of the costs incurred by states are matched by the federal government. The exact percentage varies by state because the matching rate was designed so that poorer states receive a larger share of program costs from the federal government. The states of Wyoming, South Dakota, North Dakota, spent the least on Medicaid costs in 2021.

Funding share of states set to increase Under the Affordable Care Act, states have the choice to expand their Medicaid programs to cover nearly all low-income Americans under age 65. For states that implemented the expansion, the federal government paid 100 percent of the state costs for all newly eligible adults from 2014 to 2016. The new matching rate has slowly declined since and reached 90 percent in 2020, which means states have to pick up ten percent of the bill. Governors are concerned about the rise in costs, and state expenditure is projected to increase by 50 percent between 2020 and 2027.

Graph and download economic data for Personal current transfer receipts: Government social benefits to persons: Medicare (W824RC1) from Jul 1966 to Jun 2025 about social assistance, benefits, government, personal, and USA.

This database includes the averages (2006, 2010, 2014, 2016 and 2017) of state financial condition in the United States, Medicaid spending per enrollee and a number of control variables in an analysis of the effects of Medicaid spending on state financial condition. The SPSS database is included here. The hypothesis was that the effects were significant and possibly positive. I found an offsetting effect on revenues and expenditures which nulled the overall effect on state financial condition.

This dataset reports summary level expenditure data associated with the new adult group established under the Affordable Care Act. These state expenditures are reported through the federal Medicaid Budget and Expenditure System (MBES). Notes: 1. “VIII GROUP” is also known as the “New Adult Group.” 2. The VIII Group is only applicable for states that have expanded their Medicaid programs by adopting the VIII Group. VIII Group expenditure information for the states that have not expanded their Medicaid program is noted as “N/A.” 3. States that have reported “0” either have no expenditures for that reporting category or have not yet reported expenditures for that category. 4. MCHIP expenditures are not included in the All Medical Assistance Expenditures.

description: 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.; abstract: 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.

CMS has released several information products that provide spending information for prescription drugs in the Medicare and Medicaid programs. The CMS Drug Spending Dashboards are online interactive tools that provide spending information for certain prescription drugs in the Medicare and Medicaid programs. CMS selected drugs for inclusion in the dashboards based on three criteria 1) drugs with high spending on a per user basis (Medicare Program) and drugs with high spending on a per prescription fill basis (Medicaid Program) 2) drugs with high total program spending and 3) drugs with high costs increases in recent years. The dashboard tools display relevant spending, utilization, and trend data and also include consumer-friendly information on the drug product descriptions, manufacturer(s), and uses. In addition to the Dashboards, CMS has released Medicare spending and utilization data for all Part B and Part D drugs. These summary data files were the basis for the Medicare Drug Spending Dashboard and include annual data for the most recent five years.

Medicaid CMS-64 FFCRA Increased FMAP Expenditure

  Description

During a public health emergency in the Families First Coronavirus Response Act (FFCRA), a new optional Medicaid eligibility group was added called COVID-19 testing eligibility group. States reported these expenditures under sections 6004 and 6008 through the Medicaid Budget and Expenditure System (MBES) on the Form CMS-64. The data in these reports constitute summary level preliminary expenditure information… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/medicaid-cms-64-ffcra-increased-fmap-expenditure.

This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state expenditures are tracked through the automated Medicaid Budget and Expenditure System/State Children's Health Insurance Program Budget and Expenditure System (MBES/CBES).

For more information, visit https://medicaid.gov/medicaid/finance/state-expenditure-reporting/expenditure-reports/index.html.

In the fiscal year 2023, Medicaid expenditure in California amounted to a total of about 124 billion U.S. dollars, of which 81.3 billion U.S. dollars were federal-funded and approximately 43 billion U.S. dollars were state-funded. California had, as expected, the highest spending and also the largest number of people enrolled in Medicaid in the United States. The Federal Medical Assistance Percentage (FMAP) varies by state depending on the state's per capita income compared to the national average.

Managed Long Term Services and Supports (MLTSS) Enrollees

  Description

Enrollment includes both Medicaid-only and Medicare-Medicaid (“dual”) enrollees. For both types of enrollees, Medicaid covers LTSS. For dual enrollees, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare, and other non-LTSS services that are not covered by Medicare.
Some comprehensive managed care programs enroll beneficiaries who may… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/managed-long-term-services-and-supports-mltss-enro.

Objective: A one third reduction of premature deaths from non-communicable diseases by 2030 is a target of the United Nations Sustainable Development Goal for Health. Unlike in other developed nations, premature mortality in the United States (US) is increasing. The state of Oklahoma suffers some of the greatest rates in the US of both all-cause mortality and overdose deaths. Medicaid opioids are associated with overdose death at the patient level, but the impact of this exposure on population all-cause mortality is unknown. The objective of this study was to look for an association between Medicaid spending, as proxy measure for Medicaid opioid exposure, and all-cause mortality rates in the 45–54-year-old American Indian/Alaska Native (AI/AN45-54) and non-Hispanic white (NHW45-54) populations.Methods: All-cause mortality rates were collected from the US Centers for Disease Control & Prevention Wonder Detailed Mortality database. Annual per capita (APC) Medicaid spending, and APC Medicare opioid claims, smoking, obesity, and poverty data were also collected from existing databases. County-level multiple linear regression (MLR) analyses were performed. American Indian mortality misclassification at death is known to be common, and sparse populations are present in certain counties; therefore, the two populations were examined as a combined population (AI/NHW45-54), with results being compared to NHW45-54 alone.Results: State-level simple linear regressions of AI/NHW45-54 mortality and APC Medicaid spending show strong, linear correlations: females, coefficient 0.168, (R2 0.956; P < 0.0001; CI95 0.15, 0.19); and males, coefficient 0.139 (R2 0.746; P < 0.0001; CI95 0.10, 0.18). County-level regression models reveal that AI/NHW45-54 mortality is strongly associated with APC Medicaid spending, adjusting for Medicare opioid claims, smoking, obesity, and poverty. In females: [R2 0.545; (F)P < 0.0001; Medicaid spending coefficient 0.137; P < 0.004; 95% CI 0.05, 0.23]. In males: [R2 0.719; (F)P < 0.0001; Medicaid spending coefficient 0.330; P < 0.001; 95% CI 0.21, 0.45].Conclusions: In Oklahoma, per capita Medicaid spending is a very strong risk factor for all-cause mortality in the combined AI/NHW45-54 population, after controlling for Medicare opioid claims, smoking, obesity, and poverty.

Graph and download economic data for Personal current transfer receipts: Government social benefits to persons: Medicaid (W729RC1Q027SBEA) from Q1 1966 to Q2 2025 about transfers, social assistance, receipts, benefits, government, personal, GDP, and USA.

More than one in four hospitalizations for those with both Medicare and full Medicaid coverage was potentially avoidable, according to findings reported in Medicare-Medicaid Eligible Beneficiaries and Potentially Avoidable Hospitalizations, published in Volume 4, Issue 1 of the Medicare and Medicaid Research Review. Using data from 2007 to 2009, the study examined potentially avoidable hospitalizations rates by setting, state, and medical condition, and the average cost of these events. Beneficiaries in institutions were much more likely to have these events - 16 percent of beneficiaries in the study population were in an institution, yet comprised 45 percent of all potentially avoidable hospitalizations. The range in rates per 1,000 person years across the states was considerable from a low of 59 (Utah) to a high of 197 (Mississippi), a more than a threefold difference. Five conditions were responsible for nearly 80 percent of potentially avoidable hospitalizations. From 2007 to 2009, the national and state rates were fairly consistent.

To inform HHS, States, Congress, and the public about the results and accomplishments of the State Medicaid Fraud Control Units.