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. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including PCCM, MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services. 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. "--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.

Medicaid is an important public health insurance for individuals with a low income, those that are pregnant, disabled or are children. It was projected that by 2020 there would be approximately **** million Medicaid enrollees. By 2027 that number is expected to increase to ** million individuals covered.

Medicaid in the focus

Medicaid has recently been in the news for several reasons. A proposed Medicaid expansion was announced with the implementation of the Affordable Care Act in 2010. According to the expansion, all states were given the option to expand Medicaid programs to help provide insurance coverage to millions of U.S. Americans. As of 2019, ** states have accepted federal funding to expand their Medicaid programs. Medicaid, after Medicare and private insurance, provides a significant proportion of the total health expenditures in the United States. In general, Medicaid expenditure, like the number of enrollees, has been growing over time.

Medicaid demographics

A significant proportion of Medicaid enrollees in the U.S. are children and low-income adults. Despite children accounting for most of the enrollees in the Medicaid program, the largest percentage of expenditures for Medicaid is dedicated to those enrolled as a disabled individual. Expenditures for the program also vary regionally. The states with the highest Medicaid expenditures include California, New York and Texas, to name a few.

In 2023, some 47.6 percent of Medicaid and CHIP enrollees were aged between 18 and 64 years, while adults aged 65 years accounted for only eight percent of enrollees. Medicaid program is funded jointly by the federal and the state governments, it provided coverage to nearly 19.5 percent of the U.S. population in 2022. Medicaid vs CHIPMedicaid and the Children’s Health Insurance Program (CHIP) both provide health insurance coverage for children from low-income families. Children who are not eligible for Medicaid but who would otherwise be unable to obtain insurance through a family plan are covered by CHIP. More than five million children were enrolled in CHIP in the U.S. in 2023. Medicaid and CHIP funding rateThe Federal Medical Assistance Percentages (FMAPs) are used to calculate the amount of federal matching funds for State Medicare and CHIP programs. To encourage states to expand coverage for uninsured children the federal matching rates for CHIP are generally 15 points higher than the Medicaid rate. However, unlike permanent federal funding for Medicaid, CHIP federal funding is capped and due to expire in FY 2027.

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.

Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2023. That is a significant increase from around ** million ten years earlier. Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare. From the beginning to ObamacareMedicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2022. Who is enrolled in Medicaid?Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for **** percent of total enrollment, were responsible for **** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.

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.

Total Medicaid Enrollees - VIII Group Break Out Report Reported on the CMS-64 The enrollment information is a state-reported count of unduplicated individuals enrolled in the state’s Medicaid program at any time during each month in the quarterly reporting period. The enrollment data identifies the total number of Medicaid enrollees and, for states that have expanded Medicaid, provides specific counts for the number of individuals enrolled in the new adult eligibility group, also referred to as the “VIII Group”. The VIII Group is only applicable for states that have expanded their Medicaid programs by adopting the VIII Group. This data includes state-by-state data for this population as well as a count of individuals whom the state has determined are newly eligible for Medicaid. All 50 states, the District of Columbia and the US territories are represented in these data. 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 enrollment information for the states that have not expanded their Medicaid program is noted as “N/A.”

California has more Medicaid and CHIP enrollees than any other state in the United States. As of April 2023, approximately ** million Americans were enrolled in the Medicaid health insurance programs in California, which accounted for approximately ** percent of the total number of Medicaid enrollees nationwide (**** million). Blow to Medicaid expansion plans California is one of many states that has expanded its Medicaid program under the Affordable Care Act (ACA) to encourage more low-income adults to sign up for health coverage. One of the original aims of the ACA was to limit some of the variations in state Medicaid programs, but the Supreme Court ruled that the expansion should be optional. Governors of the states that did not expand said they were concerned about long-term costs. California is the leading state for Medicaid expenditure, spending approximately **** billion U.S. dollars in FY2020. Health coverage for children The Children’s Health Insurance Program (CHIP) was created as a complement to Medicaid, expanding the reach of government-funded health coverage to more children in low-income families. As of May 2021, over **** million children were enrolled in Medicaid/CHIP programs in California, more than any other state. As of January 2021, the median Medicaid/CHIP eligibility level for children was *** percent of the federal poverty level.

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.

This dataset aggregates and displays the number of New York State Medicaid enrollees by eligibility year and month within each NYS Economic Region; health insurance plan information; and enrollee demographics. For more information, check out http://www.health.ny.gov/health_care/medicaid/, or go to the "About" tab.

This dataset represents the number of Medicaid eligible individuals receiving the various Medicaid services over time.

Children accounted for **** percent of Medicaid enrollees in 2022, which was the largest share of all enrollment groups. The elderly and persons with disabilities had the smallest shares, but together they accounted for ************** 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 **** 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.

The CMS Program Statistics - Medicare-Medicaid Enrollment tables provide data on characteristics of the Medicare-Medicaid enrollee population. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR ENROLL AB 40. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility, Yearly Trend MDCR ENROLL AB 41. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and by Demographic Characteristics MDCR ENROLL AB 42. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and Area of Residence MDCR ENROLL AB 43. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility, Yearly Trend MDCR ENROLL AB 44. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility and by Demographic Characteristics MDCR ENROLL AB 45. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility and Area of Residence MDCR ENROLL AB 46. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility, Yearly Trend MDCR ENROLL AB 47. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility and by Demographic Characteristics MDCR ENROLL AB 48. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility and Area of Residence

In 2023, just four in ten Medicaid/CHIP enrollees were White, non-Hispanic. In comparison, roughly three-quarters of Medicare beneficiaries were White. The Affordable Care Act (ACA) Medicaid expansion in 2014, has helped reduce racial disparities in access to healthcare in the United States. Medicaid eligibility Medicaid provides health coverage to certain low-income individuals, families, children, pregnant women, the elderly, and persons with disabilities. Each state has its own Medicaid eligibility criteria in accordance with federal guidelines. As a result, Medicaid eligibility and benefits differ widely from state to state. Medicaid expansion provision under the Affordable Care Act (ACA) allows states to provide coverage for low-income adults by expanding eligibility for Medicaid to 138 percent of the federal poverty line (FPL). Medicaid coverage gap Uninsured individuals who live in states that have chosen not to expand Medicaid under the Affordable Care Act (ACA) are referred to as being in the Medicaid coverage gap. As of January 2021, 12 states have not adopted the Medicaid expansion provision under the Affordable Care Act (ACA). More than two million uninsured adults fall into this coverage gap, and among them, more than 60 percent are people of color.

This data set includes annual counts and percentages of Medicaid enrollees who are eligible for benefits based on disability, overall; by reason for qualification of disability benefits; and by four subpopulation topics: age group, dual eligibility status, race and ethnicity, and managed care participation. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. The Children’s Health Insurance Program (CHIP) does not confer eligibility based on disability, so Medicaid expansion CHIP (M-CHIP) and separate CHIP (S-CHIP) enrollees are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the dual eligibility, race and ethnicity, and managed care participation subpopulation topics are restricted to working-age adults (ages 19 to 64) with comprehensive Medicaid benefits. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid enrollees who qualify for benefits based on disability in 2020." Enrollees are assigned to a disability category based on their latest reported eligibility group code and age in the calendar year. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a dual eligibility status subpopulation based on the dual eligibility code that applies to the majority of their enrolled-months during the year (Dual Eligibility Code). Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to a managed care participation subpopulation based on the managed care plan type code that applies to the majority of their enrolled-months during the year (Enrollment in CMC Plans). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees by urban or rural residence. Results are shown overall; by state; and by four subpopulation topics: scope of Medicaid and CHIP benefits, race and ethnicity, disability-related eligibility category, and managed care participation. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. Results shown overall (where subpopulation topic is "Total enrollees") and for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the race and ethnicity, disability category, and managed care participation subpopulation topics only include Medicaid and CHIP enrollees with comprehensive benefits. Results shown for the disability category subpopulation topic only include working-age adults (ages 19 to 64). Results for states with TAF data quality issues in the year have a value of "Unusable data." Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Rural Medicaid and CHIP enrollees in 2020." Enrollees are assigned to an urban or rural category based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF. Enrollees are assigned to the comprehensive benefits or limited benefits subpopulation according to the criteria in the "Identifying Beneficiaries with Full-Scope, Comprehensive, and Limited Benefits in the TAF" DQ Atlas brief. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to a disability category subpopulation using their latest reported eligibility group code and age in the year (Medicaid enrollees who qualify for benefits based on disability in 2020). Enrollees are assigned to a managed care participation subpopulation based on the managed care plan type code that applies to the majority of their enrolled-months during the year (Enrollment in CMC Plans). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

The number of people enrolled in Medicaid decreased by *** percent in 2024, while expenditure increased by *** percent. Due to Medicaid unwinding in 2025 Medicaid enrollment is projected to decline by *** percent, while the spending is expected to grow by *** percent. Impact of COVID-19 on Medicaid Approximately ** percent of Americans were covered by Medicaid in 2020. The total number of Medicaid enrollees continues to increase each year and is projected to surpass ** million in 2019. A steadily improving economy in the United States is one reason for the slower enrollment growth experienced in recent years. However, unemployment numbers surged due to the COVID-19 pandemic, and Medicaid enrollment is expected to rise over the coming months as millions of people lose their employer-based health insurance. Medicaid expenditure set to increase Medicaid expenditure in 2019 was projected to *** billion U.S. dollars, an increase year on year. Medicaid spending rose by *** percent in 2020, but the economic downturn caused by COVID-19 is likely to significantly increase both state and federal expenditures. More people are now eligible for Medicaid because they have lost income, and the costs of coronavirus testing and treatment are escalating. Many states may not have the budget to pay for it all, especially at a time when tax revenues are declining.

Dataset

This dataset was created by NamitaSharma3

Contents

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees who received a well-child visit paid for by Medicaid or CHIP, overall and by five subpopulation topics: age group, race and ethnicity, urban or rural residence, program type, and primary language. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. Results include enrollees with comprehensive Medicaid or CHIP benefits for all 12 months of the year and who were younger than age 19 at the end of the calendar year. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the primary language subpopulation topic exclude select states with data quality issues with the primary language variable in TAF. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid and CHIP enrollees who received a well-child visit in 2020." Enrollees are identified as receiving a well-child visit in the year according to the Line 6 criteria in the Form CMS-416 reporting instructions. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to a program type subpopulation based on the CHIP code and eligibility group code that applies to the majority of their enrolled-months during the year (Medicaid-Only Enrollment; M-CHIP and S-CHIP Enrollment). Enrollees are assigned to a primary language subpopulation based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

As of September 2025, approximately *** million Medicaid enrollees have been disenrolled in Texas, the highest number of people disenrolled across all states in the United States. Overall, more than **** 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.