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.

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 percentage of Americans covered by the Medicaid public health insurance plan increased from **** percent in 2020 to around **** percent in 2023. However, the percentage of those insured through Medicaid remains lower than the peak of **** percent in 2015. The expansion of Medicaid The Affordable Care Act (ACA) provided the option for states to expand Medicaid eligibility to people whose income was below a particular threshold. The ACA’s major coverage expansion came into force in 2014, and the number of individuals estimated to be enrolled in Medicaid has since surpassed ** million. More than ** million children were enrolled in the program in 2018, representing ** percent of overall Medicaid enrollment. State Medicaid coverage Initially, the ACA mandated that all state Medicaid programs would have to be extended to provide medical coverage to nearly all low-income groups. However, the Supreme Court rejected that part of the act in 2012, leaving the door open for states to make their own decision on whether they expand their plans. As of September 2021, ** states plus the District of Columbia have adopted the Medicaid expansion.

The number of older individuals – those aged 65 and older – enrolled in the Medicaid health insurance program was projected to be *** million in 2020. Enrollment is expected to increase year-on-year and is forecast to reach ***** million by 2027.

Which enrollment group is the largest? The percentage of people covered by Medicaid has notably increased since 2000, and enrollment has accelerated in recent years due to the program’s expansion under the Affordable Care Act. The elderly represent the smallest enrollment group, and this looks set to continue in the coming years. The number of disabled enrollees is projected to grow to nearly ****** million, while children are expected to remain the largest enrollment group.

Combining Medicaid and Medicare Aged individuals can qualify for Medicaid based on their low-income or via another eligibility pathway, such as receiving Supplemental Security Income. Some seniors may also qualify for both Medicaid and Medicare, and these dual-eligible beneficiaries receive a comprehensive range of medical support. Medicare is a health insurance program primarily aimed at individuals aged 65 and older – this group accounted for around ** percent of all Medicare enrollees in 2019.

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The Patient Protection and Affordable Care Act (ACA) relies heavily on the expansion of Medicaid eligibility to cover uninsured populations. In February 2008, Wisconsin expanded and reformed its Medicaid CHIP program and, as part of program implementation, automatically enrolled a set of newly eligible parents and children. This process of auto enrollment targeted newly eligible parents and older children whose children siblings were already enrolled in the states Medicaid CHIP program. Auto enrollment brought over 44,000 individuals into the program, representing more than 60 percent of all enrollees in the first month of the reformed program. Individuals who were auto enrolled were modestly more likely to leave the program relative to other individuals who enrolled in February 2008, unless their incomes were high enough to be required to pay premiums. These auto enrollees were much more likely to exit relative to other enrollees subject to premium payments. The higher exit rates exhibited by non premium paying auto enrollees were likely due to the fact that over 40 percent of auto enrollees were covered by a private insurance policy in the month of their enrollment, compared to approximately 30 percent for regular enrollees. A national simulation of an auto enrollment process similar to Wisconsins, including the expansion of adult Medicaid eligibility to 133 percent of the federal poverty level under the ACA, suggests that 2.5 million of the 5.6 million newly eligible parents could be auto enrolled, and approximately 25 percent of this population would be privately insured. These results suggest that auto enrollment may be appropriate for other states, especially in their efforts to enroll eligible populations who are not subject to premium requirements.

The Patient Protection and Affordable Care Act (ACA) relies heavily on the expansion of Medicaid eligibility to cover uninsured populations. In February 2008, Wisconsin expanded and reformed its Medicaid CHIP program and, as part of program implementation, automatically enrolled a set of newly eligible parents and children. This process of auto enrollment targeted newly eligible parents and older children whose children siblings were already enrolled in the states Medicaid CHIP program. Auto enrollment brought over 44,000 individuals into the program, representing more than 60 percent of all enrollees in the first month of the reformed program. Individuals who were auto enrolled were modestly more likely to leave the program relative to other individuals who enrolled in February 2008, unless their incomes were high enough to be required to pay premiums. These auto enrollees were much more likely to exit relative to other enrollees subject to premium payments. The higher exit rates exhibited by non premium paying auto enrollees were likely due to the fact that over 40 percent of auto enrollees were covered by a private insurance policy in the month of their enrollment, compared to approximately 30 percent for regular enrollees. A national simulation of an auto enrollment process similar to Wisconsins, including the expansion of adult Medicaid eligibility to 133 percent of the federal poverty level under the ACA, suggests that 2.5 million of the 5.6 million newly eligible parents could be auto enrolled, and approximately 25 percent of this population would be privately insured. These results suggest that auto enrollment may be appropriate for other states, especially in their efforts to enroll eligible populations who are not subject to premium requirements.

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.

Eligibility and benefit characteristics of Medicaid enrollees with SCD.

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.

In the state of California, there were approximately *** million children enrolled in Medicaid and CHIP insurance plans in March 2025. Additionally, Texas, New York, and Florida all had more than *** million children enrolled in the programs. How many people are enrolled in Medicaid/CHIP? State Medicaid programs provide medical coverage to millions of Americans, including children, pregnant women, and parents. The Children’s Health Insurance Program (CHIP) was introduced in 1997 to help uninsured children who were previously not eligible for Medicaid. The total number of individuals enrolled in Medicaid and CHIP was approximately **** million in May 2021, and California has the largest state program. How is income eligibility determined? The Affordable Care Act established a new methodology to assess income eligibility for Medicaid and CHIP. The adoption of the Modified Adjusted Gross Income (MAGI) methodology helped to align eligibility rules that previously varied nationwide. In general, an individual’s eligibility is now determined by their MAGI and where it falls in relation to the federal poverty level (FPL). For Medicaid and CHIP plans across all states in 2021, the median upper income eligibility level for children was *** percent of the FPL.

This indicator provides information about medically underserved areas and/or populations (MUA/Ps), as determined by the federal Health Resources and Services Administration (HRSA). Each designated area includes multiple census tracts.State Primary Care Offices submit applications to HRSA to designate specific areas within counties as MUA/Ps. The MUA/P designation is made using the Index of Medical Underservice (IMU) score, which includes four components: provider per 1,000 population, percent of population under poverty, percent of population ages 65 years and older, and infant mortality rate. The IMU scores ranges from 0-100. Lower scores indicate higher needs. An IMU score of 62 or below qualifies for designation as an MUA/P. Note: if an area is not designated as an MUA/P, it does not mean it is not underserved, only that an application has not been filed for the area and that official designation has not been given.The MUAs within Los Angeles County consist of groups of urban census tracts (namely service areas). MUPs have a shortage of primary care health services for a specific population within a geographic area. These populations may face economic, cultural, or language barriers to health care, such as: people experiencing homelessness, people who are low-income, people who are eligible for Medicaid, Native Americans, or migrant farm workers. All the MUPs that have been designated within Los Angeles County are among low-income populations of selected census tract groups. Due to the nature of the designation process, a census tract may be designated as both an MUA and an MUP and as multiple MUAs. MUA/P designations help establish health maintenance organizations or community health centers in high-need areas.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

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.

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 number of disabled persons enrolled in Medicaid was projected to reach ************** in 2020. This enrollment group is expected to increase over the coming years and could reach ************ by 2027.

Disabled enrollees by state Medicaid is a public health insurance program that provides medical coverage to millions of Americans. Disabled individuals represent around ** percent of all Medicaid enrollees – children aged 18 years and under are the largest enrollment group. The state of California, which has the highest Medicaid expenditure, had slightly more than *********** disabled enrollees in 2014.

SSI beneficiaries will receive Medicaid The Affordable Care Act (ACA) created the opportunity for states to expand Medicaid and cover more low-income adults aged 64 years and under. The ACA established a new methodology to determine income eligibility for Medicaid. However, some mandatory groups are exempt from these income-based rules, including those individuals receiving Supplemental Security Income (SSI). The SSI program provides financial assistance to disabled persons, and beneficiaries are automatically eligible for Medicaid.

This indicator provides information about health professional shortage areas (HPSAs) for mental health services as determined by the federal Health Resources and Services Administration (HRSA). Each designated area includes multiple census tracts.HPSAs can be geographic areas, populations, or health care facilities that have been designated as having a shortage of health professionals. Geographic HPSAs have a shortage of providers for an entire population in a defined geographic area. Population HPSAs have a shortage of providers for a subpopulation in a defined geographic area, such as low-income populations, people experiencing homelessness, and migrant farmworker populations. In Los Angeles County, facility HPSAs include:•Federally Qualified Health Centers (FQHCs); •FQHC Look-A-Likes (LALs); •Indian Health Service, Tribal Health, and Urban Indian Health Organizations; •correctional facilities; • and some other facilities. For these indicators, we include HPSAs in Los Angeles County with statuses listed as “Designated” or “Proposed for Withdrawal” (but not withdrawn yet). Due to the nature of the designation process, a census tract may be designated as any combination of geographic and population HPSAs and three categories of care (i.e., primary, dental, and mental health care). Facility HPSAs may also cover multiple types of care.State Primary Care Offices submit applications to HRSA to designate certain areas within counties as HPSAs for primary care, dental, and mental health services. HRSA’s National Health Service Corps calculates HPSA scores to determine priorities for assignment of clinicians. The scores range from 0 to 25 for mental health, where higher scores indicate greater priority. All HPSA categories shared three scoring criteria: (1) population-to-provider ratio, (2) percent of population below 100% of the Federal Poverty Level, and (3) travel time to the nearest source of care outside the HPSA designation area. Each category also has additional criteria that go into the scores. Specifically, mental health HPSA scoring includes elderly ratio (percent of people over age 65), youth ratio (percent of people under age 18), alcohol abuse prevalence, and substance abuse prevalence. Note: if an area is not designated as an HPSA, it does not mean it is not underserved, only that an application has not been filed for the area and that an official designation has not been given.HPSA designations help distribute participating health care providers and resources to high-need communities.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

According to a survey done in March 2024, long wait times on the phone was the most common problem reported by 44 percent of Americans who tried to renew their Medicaid coverage last year before Medicaid unwinding. Another 26 percent mentioned that they did not know what documents were needed to complete re-enrollment. This statistic illustrates the types of problems Medicaid enrollees experienced when they tried to renew their coverage in 2023.

Medicare is an important public health insurance scheme for U.S. adults aged 65 years and over. As of 2023, an estimated 18.9 percent of the U.S. population was covered by Medicare, an increase from the previous year. As of 2021, California, Florida, and Texas had the largest number of adults aged 65 years and older. The Medicare program Medicare has two primary parts: Medicare Part A covers hospital care and Medicare Part B covers medical and preventative services. Both parts of Medicare are available to those aged 65 years and older under certain conditions. Medicare premiums are variable and depend on the enrollee’s income. Despite a majority of the Medicare enrollees being above the federal poverty line, there are still several programs in place to help cover the costs of healthcare for the elderly. Opinions on elderly care in the U.S. It is estimated that about 23 percent of Medicare enrollees are in fair/poor health. But there are lots of questions about who should pay for or help with elderly care long-term. In a recent survey of U.S. adults, about half of the respondents said that health insurance companies should pay for elderly care. However, a majority of adults also supported a long-term government sponsored health plan like Medicaid. The issue is still hotly debated and politicized in the United States.

In 2022, approximately ***** percent of people aged 65 years and older in the United States had Medicaid health insurance coverage, this was an increase from the previous year. This statistic illustrates the distribution of people aged 65 years and above with Medicaid coverage in the United States from 2017 to 2023.

In 1970, some 7.5 billion U.S. dollars were spent on the Medicare program in the United States. Fifty plus years later, this figure stood at 1,122.1 billion U.S. dollars. This statistic depicts total Medicare spending from 1970 to 2024. Increasing Medicare coverage Medicare is the federal health insurance program in the U.S. for the elderly and those with disabilities. In the U.S., the share of the population with any type of health insurance has increased to over 90 percent in the past decade. As of 2019, approximately 18 percent of the U.S. population was covered by Medicare in particular. Increasing Medicare costs Medicare costs are forecasted to continue increasing over time, with outlays rising to a predicted 1.78 trillion U.S. dollars by 2031 as the population continues to age. Certain diseases of old age, such as Alzheimer’s disease, are increasing in prevalence in the U.S., which will reflect on healthcare costs for the elderly. In 2021, Alzheimer's disease was estimated to cost Medicare and Medicaid around 239 billion U.S. dollars in care costs; by 2050, this number is projected to climb to 798 billion dollars.

As of 2023, nearly *** million people in the United States had some kind of health insurance, a significant increase from around *** million insured people in 2010. However, as of 2023, there were still approximately ** million people in the United States without any kind of health insurance. Insurance coverage The United States does not have universal health insurance, and so health care cost is mostly covered through different private and public insurance programs. In 2021, almost ** percent of the insured population of the United States were insured through employers, while **** percent of people were insured through Medicaid, and **** percent of people through Medicare. As of 2022, about *** percent of people were uninsured in the U.S., compared to ** percent in 2010. The Affordable Care Act The Affordable Care Act (ACA) significantly reduced the number of uninsured people in the United States, from **** million uninsured people in 2013 to **** million people in 2015. However, since the repeal of the individual mandate the number of people without health insurance has risen. Healthcare reform in the United States remains an ongoing political issue with public opinion on a Medicare-for-all plan consistently divided.