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.

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.

These data track state Medicaid programs' policies for paying Medicare's cost sharing for low-income individuals who have Medicare and Medicaid ("dual eligibles"). Our database focuses on Medicaid policies for paying the cost sharing for outpatient and physician services covered by the Medicare Part B program. We track state policies longitudinally from 2004-2018 based on information abstracted from online Medicaid policy documents, legal databases, and policy data reported to us by 22 state Medicaid programs. We also developed a Medicaid payment index, which reflects the proportion of the Medicare Part B allowed amount (i.e., price) for physician office visits that providers would expect to be paid per service provided to a dual eligible patient, in aggregate from Medicare and Medicaid, given these state policies. One version of this index reflects payments to physicians who qualified for higher Medicaid fees under the Affordable Care Act's Medicaid Fee Bump (implemented nationally from 2013-14) and one version reflects payments to physicians who were ineligible for the fee bump.Download the attached Excel files to retrieve the database and additional documentation. The compressed folder 'final document library' contains the original source policy documents (in PDF format) that are catalogued in the database.More detail about this database and our findings can be found in the article:Roberts ET, Nimgaonkar A, Aarons J, Tomko H, Shartzer A, Zuckerman SB, and James AE. "New Evidence of State Variation in Medicaid Payment Policies for Low-Income Medicare Beneficiaries," Health Services Research 2020 (doi: 10.1111/1475-6773.13545).

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

In 2023, Medicaid financed over *** thousand births in Texas, the largest number of births financed by Medicaid across all states in the United States. Medicaid is the largest source of funding for health-related services for pregnant women, infants and children in the United States. This statistic illustrates the number of births financed by Medicaid in the U.S. in 2023, by state.

All states (including the District of Columbia) are required to provide data to The Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) indicators related to key application, eligibility, enrollment and call center processes. These data reflect enrollment activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, as well as state program performance. States submit this data via the Performance Indicator dataset. Further information about this dataset is available at: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance/index.html.

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.

Federal law requires that state Medicaid programs make Disproportionate Share Hospital (DSH) payments to qualifying hospitals that serve a large number of Medicaid and uninsured individuals. State-specific annual DSH reports are posted as submitted by states based on their availability. For more information, visit https://www.medicaid.gov/medicaid/finance/dsh/index.html.

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.

The New York State Department of Health (NYS DOH) shares de-identified and aggregated metrics on the NYS Medicaid program through the Health Data NY catalog and as summary statistics on DOH website. Datasets vary by subject/scope, unit of analysis, years of data collection, and update frequency. Publicly-available datasets in the Health Data NY catalog address topics including:

• Medicaid Program Enrollment Rates and Demographics
• Health Home Quality and Utilization
• Inpatient Admissions and Emergency Room Visits
• Incentive Payments
• Inpatient Potentially Preventable Readmission (PPR) Rates
• Newborn Low Birth Weight Rates
• Pediatric and Adult Discharge Quality Indicators
• Potentially Preventable Emergency Visit (PPV) Rates
• Potentially Avoidable Antibiotic Prescribing Rates

For a fee, researchers at NYU Langone Health may acquire NYS Medicaid claims data by submitting a study proposal to the Health Evaluation and Analytics Lab (HEAL). For more information, click on the link to the NYS Medicaid Claims File under the Related Datasets section or search for the NYS Medicaid Claims File in the NYU Data Catalog.

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.

Graph and download economic data for Effect of the American Recovery and Reinvestment Act (ARRA) on Federal Government Current Transfer Payments: Grants-In-Aid to State and Local Governments: Medicaid (DISCONTINUED) (MEDICAQ027SBEA) from Q1 2009 to Q1 2013 about ARRA, grants, transfers, state & local, payments, federal, government, and USA.

This dataset shows aggregated Medicaid payments, client participation, recipients, bed hold days, and other days by vendors/health care providers by month in Iowa starting with July 2011. Vendors within this dataset fall into the following categories: Skilled Nursing Facilities, Intermediate Care Facilities, Residential Care Facilities, State Operated - Intermediate Care Facilities for Individuals with Mental Disabilities, Community-Based Intermediate Care Facilities for Individuals with Mental Disabilities, and Nursing Facilities for the Mentally Ill.

The Medicaid by Drug dataset presents information on spending for covered outpatient drugs prescribed to beneficiaries enrolled in Medicaid by physicians and other healthcare professionals. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. Units refer to the drug unit in the lowest dispensable amount. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications. Drug spending metrics for Medicaid represent the total amount reimbursed by both Medicaid and non-Medicaid entities to pharmacies for the drug. Medicaid drug spending contains both the Federal and State reimbursement and is inclusive of any applicable dispensing fees. In addition, this total is not reduced or affected by Medicaid rebates paid to the states.

The Medicare Home Health Agency tables provide use and payment data for home health agencies. The tables include use and expenditure data from home health Part A (Hospital Insurance) and Part B (Medical Insurance) claims.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data.

Below is the list of tables:

MDCR HHA 1. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR HHA 2. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR HHA 3. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Area of Residence MDCR HHA 4. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, Type of Agency and Type of Service Visit MDCR HHA 5. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, by Type of Control and Type of Service Visit MDCR HHA 6. Medicare Home Health Agencies: Persons with Utilization, Total Service Visits, and Program Payments for Original Medicare Beneficiaries, by Number of Service Visits and Number of Episodes

This data set includes monthly counts and rates (per 1,000 beneficiaries) of perinatal care, including prenatal visits, prenatal bundled payments, postpartum visits, and postpartum bundled payments, for female Medicaid and CHIP beneficiaries ages 15 to 44 (as of the first day of the month), by state. 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 perinatal care 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, Procedure Codes - OT Professional, Claims Volume - 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.

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.

Between 2020 and 2027, both federal government and state spending are projected to increase by around 50 percent. During this period, federal expenditure is expected to rise from 419 billion U.S. dollars to approximately 625 billion U.S. dollars.

Growth in state Medicaid spending The expansion of the Affordable Care Act created an incentive for states: if they extended their health care programs, the federal government would fully fund coverage for all of the newly eligible non-elderly adults. However, the matching rate started to decline from 2017, and states had to start contributing towards the new beneficiaries. In 2020, the federal government’s matching rate dropped to 90 percent, and this is expected to have a noticeable impact on Medicaid state spending.

The impact of the coronavirus on state budgets Total Medicaid enrollment is expected to increase in the coming months due to the COVID-19 pandemic. The economic downturn has resulted in widespread job losses, and many people will subsequently lose their employer-based health coverage. States are not only left facing higher than expected Medicaid costs, but they will also receive lower income tax revenues due to people being out of work and may have to pay out more in unemployment benefit payments.

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.

We are releasing data that compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of May 15, 2020. This data is already available on other websites, but this chart brings the information together into one view for comparison. You can find additional information on the Accelerated and Advance Payments at the following links:

Fact Sheet: https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf;

Zip file on providers in each state: https://www.cms.gov/files/zip/accelerated-payment-provider-details-state.zip

Medicare Accelerated and Advance Payments State-by-State information and by Provider Type: https://www.cms.gov/files/document/covid-accelerated-and-advance-payments-state.pdf.

This file was assembled by HHS via CMS, HRSA and reviewed by leadership and compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of December 4, 2020.

HHS Provider Relief Fund President Trump is providing support to healthcare providers fighting the coronavirus disease 2019 (COVID-19) pandemic through the bipartisan Coronavirus Aid, Relief, & Economic Security Act and the Paycheck Protection Program and Health Care Enhancement Act, which provide a total of $175 billion for relief funds to hospitals and other healthcare providers on the front lines of the COVID-19 response. This funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19. HHS is distributing this Provider Relief Fund money and these payments do not need to be repaid. The Department allocated $50 billion of the Provider Relief Fund for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' net reimbursement. It allocated another $22 billion to providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers who serve low-income populations and uninsured Americans. HHS will be allocating the remaining funds in the near future.

As part of the Provider Relief Fund distribution, all providers have 45 days to attest that they meet certain criteria to keep the funding they received, including public disclosure. As of May 15, 2020, there has been a total of $34 billion in attested payments. The chart only includes those providers that have attested to the payments by that date. We will continue to update this information and add the additional providers and payments once their attestation is complete.

CMS Accelerated and Advance Payments Program On March 28, 2020, to increase cash flow to providers of services and suppliers impacted by the coronavirus disease 2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. Beginning on April 26, 2020, CMS stopped accepting new applications for the Advance Payment Program, and CMS began reevaluating all pending and new applications for Accelerated Payments in light of the availability of direct payments made through HHS’s Provider Relief Fund.

Since expanding the AAP program on March 28, 2020, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals, through May 18, 2020. For Part B suppliers—including doctors, non-physician practitioners and durable medical equipment suppliers— during the same time period, CMS approved almost 24,000 applications advancing $40.4 billion in payments. The AAP program is not a grant, and providers and suppliers are required to repay the loan.

CMS has published AAP data, as required by the Continuing Appropriations and Other Extensions Act of 2021, on this website: https://www.cms.gov/files/document/covid-medicare-accelerated-and-advance-payments-program-covid-19-public-health-emergency-payment.pdf. Requests for additional data related to the program must be submitted through the CMS FOIA office. For more information on how to submit a FOIA request please visit our website at https://www.cms.gov/Regulations-and-Guidance/Legislation/FOIA. The PRF is administered by the Health Resources & Services Administration (HRSA). For more information on how to submit a request for unpublished program data from HRSA, please visit https://www.hrsa.gov/foia/index.html.

Provider Relief Fund Data - https://data.cdc.gov/Administrative/Provider-Relief-Fund-COVID-19-High-Impact-Payments/b58h-s9zx