The number of children enrolled in Medicaid was projected to reach 31 million by 2027, which would account for nearly 40 percent of total enrollment. Historically, children have been the largest group of Medicaid enrollees.

CHIP builds on Medicaid’s coverage The Children’s Health Insurance Program (CHIP) provides insurance coverage to children in families with incomes too high to qualify for Medicaid but too low to pay for private health insurance – there were approximately 9.6 million CHIP enrollees in 2018. CHIP is jointly financed by states and the federal government, but each state can decide how to design its program: they can implement it by expanding Medicaid, creating a separate plan, or a combination of both approaches.

Income eligibility levels for children The introduction of the Affordable Care Act (ACA) strengthened children’s health coverage by expanding eligibility levels in all states. For children of all ages, the ACA established a minimum Medicaid eligibility level of 138 percent of the federal poverty level (FPL), but many states have set higher income limits. In 2020, the median upper income eligibility level for children for Medicaid/CHIP was 255 percent of the FPL.

In 2023, 35.7 percent of children aged 19 and under in the U.S. had Medicaid health insurance, this share was slightly higher in comparison to the previous year. This statistic illustrates the distribution of children aged 19 and under with Medicaid coverage in the United States (U.S.) from 2017 to 2023.

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.

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.

In 2020, just over half of all uninsured children lived in states that had not expanded Medicaid under the Affordable Care Act (Obamacare) despite the fact that only 35.2 percent of U.S. children lived in a non-expansion state. Moreover, the uninsured rate of these children was twice as high as those living in states that had expanded Medicaid. This statistic depicts the distribution and rate of children without health insurance in the U.S. in 2020, by state Medicaid expansion status.

There were approximately 28.1 million children enrolled in the Medicaid health care program in 2018, which accounted for nearly 40 percent of the total number of 74 million Medicaid enrollees. Enrollment numbers in each of the four groups have been consistent for several years.

Medicaid expenditure by eligibility group Medicaid is a joint federal and state health care program in the United States. States administer the program, but they must meet some core federal requirements, one of which includes providing health coverage to children in some low-income families. Medicaid expenditure on children was estimated to have totaled 107.2 billion U.S. dollars in 2017, which accounted for nearly 20 percent of the total expenditure during the year – the only enrollment group with a larger share of expenditures was persons with disabilities.

Health insurance options for children The Children’s Health Insurance Program (CHIP) was signed into U.S. law in 1997 and increased health coverage to uninsured children under the age of 19 who were not eligible for Medicaid. States can implement CHIP by expanding Medicaid or operating it as a separate program. More than 9.6 million children were enrolled in the program during 2018, around two million of whom were in the state of California.

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 Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) is the largest publicly available all-payer pediatric inpatient care database in the United States, containing data from two to three million hospital stays each year. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, such as congenital anomalies, as well as uncommon treatments, such as organ transplantation. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. The KID is a sample of pediatric discharges from 4,000 U.S. hospitals in the HCUP State Inpatient Databases yielding approximately two to three million unweighted hospital discharges for newborns, children, and adolescents per year. About 10 percent of normal newborns and 80 percent of other neonatal and pediatric stays are selected from each hospital that is sampled for patients younger than 21 years of age. The KID contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes discharge status, diagnoses, procedures, patient demographics (e.g., sex, age), expected source of primary payment (e.g., Medicare, Medicaid, private insurance, self-pay, and other insurance types), and hospital charges and cost. Restricted access data files are available with a data use agreement and brief online security training.

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.

Around ** percent of children in the U.S. with Medicaid born during 2019-2020 had received at least one dose of an MMR vaccine by age 24 months. This statistic illustrates the share of children with Medicaid in the United States born during 2019-2020 who had received select vaccinations by age 24 months.

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.

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.

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.

In 2015, Medicaid/CHIP participation in the state of Vermont reached 98.7 percent among all eligible children. Several other states, including Alabama and West Virginia, all had participation rates that surpassed 95 percent.

Enrollment projected to increase Medicaid and the Children’s Health Insurance Program (CHIP) combined to provide insurance to around 35 million children in April 2019, with California covering the largest number of enrollees. The Medicaid program alone covers approximately 28 million children across the United States, which represents the largest enrollment group. A steady increase in the number of children covered by the program is expected in the next few years.

How are both programs funded? Medicaid and CHIP differ in terms of size and design, but both are jointly financed by the federal and state governments. For the Medicaid program, the federal government matches costs incurred by states at a 50 percent rate. However, the federal government pays a larger share of costs in poorer states – California had the highest Medicaid expenditure in 2018. An enhanced federal matching rate, which is generally 15 percentage points higher than the Medicaid rate, was created as an incentive for states to expand their CHIP programs.

In 2020, nearly two-thirds of all uninsured children (4.3 million) were actually eligible for Medicaid or CHIP and a further 11 percent were eligible for marketplace subsidies. Therefore a focus of health policy needs to be on the outreach of these already eligible children to overcome difficulties such as language barriers, administrative barriers, or lack of internet access. This statistic presents the distribution of children without health insurance who are eligible for health coverage in the U.S. in 2020, by eligibility status.

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.

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.

As of 2020, 26 states had premium or enrollment fees and 21 states had cost sharing requirements for CHIP. States can establish premiums and cost sharing for Medicaid and CHIP under certain restrictions, such as when enrollees' household income is above a certain percentage of the federal poverty level. This statistic shows the number of U.S. states with Medicaid/CHIP premiums, enrollment fees, and cost sharing requirements for children as of January 1, 2020.

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.