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

In 2022, Medicaid expenditure totaled around 805 billion U.S. dollars, the highest in the provided time interval. The federal government paid approximately 70 percent of total Medicaid expenditures in 2022, with states picking up the other 30 percent. Medicaid’s high-cost enrollees Spending on aged enrollees and individuals with disabilities accounted for more than half of the total Medicaid expenditure in 2021. One reason why this share is so high is that these groups require greater health care, and often the services are more costly. Spending on long-term care services, which includes nursing facilities and home health care, totaled approximately 154 billion U.S. dollars in 2022. Overall, long-term care services accounted for around 20 percent of all Medicaid expenditure in 2022. The basics of Medicaid funding Medicaid is a joint federal and state health care plan, and the costs of administering the program are split between the two. States report their Medicaid costs to the federal government on a quarterly basis, and the federal government matches those costs based on a formula. This formula is designed so that the federal government pays a larger share of costs in poorer states, but in general, state costs are matched by the federal government at a 50 percent rate. California was the state with the highest Medicaid costs in 2022.

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

This data package contains the information of Medicare and Medicaid healthcare spending and healthcare cost and percentages by state.

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.

The statistic represents the total Medicaid spending projections from 2018 to 2029, as a percentage of the gross domestic product. Medicaid spending totaled to 389 billion U.S. dollars in 2018, which was about 1.9 percent of the U.S. GDP.

During a public health emergency in the Families First Coronavirus Response Act (FFCRA), a new optional Medicaid eligibility group was added called COVID-19 testing eligibility group. States reported these expenditures under sections 6004 and 6008 through the Medicaid Budget and Expenditure System (MBES) on the Form CMS-64. The data in these reports constitute summary level preliminary expenditure information related to these FFCRA provisions for each state

Notes: 1. The Families First Coronavirus Response Act (FFCRA), enacted on March 18, 2020, provided a temporary FMAP increase to states and territories meeting certain qualifications and added a new optional
Medicaid eligibility group for uninsured individuals during a public health emergency in section 1902(a)(10)(A)(ii)(XXIII) of the Act, referred to as the “COVID - 19 Testing Group.”
2. FFCRA Section 6008 provides a temporary 6.2 percentage point FMAP increase to each qualifying state and territory's FMAP under section 1905(b) of the Act, beginning January 1, 2020 and lasting through
the end of the quarter in which the public health emergency (PHE) declared by the Secretary for COVID-19 ends, including any extensions.
3. FFCRA Section 6004 provides a 100 percent match rate for individuals eligible under the new optional Medicaid eligibility group in section 1902(a)(10)(A)(ii)(XXIII) of the Act, beginning no earlier than
March 18, 2020 and lasting through the end of the PHE for COVID-19.
4. States that have reported “0” either have no expenditures for that reporting category or have not yet reported expenditures for that category.
5. This report is a cumulative summary report that includes current and prior period adjustment expenditures that apply to this quarter 6. For the Quarter ending 03/31/2020: Delaware has Negative Total Computable Expenditures and Total Federal Share Expenditures due to the reporting of prior period adjustments during this period.
7. For the Quarter ending 09/30/2020: Colorado has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
8. For the Quarter ending 03/31/2021: California has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period. This corrected FY 2020 Q4 expenditures for Treatment services that are not allowed for Section 6004 100% FMAP match. 9. For the Quarter ending 03/31/2021: Utah has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period. 10. For the Quarter ending 12/31/2022: California has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period. 11. For the Quarter ending 12/31/2022: Connecticut has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period. 12. For the Quarter ending 09/30/2023: Connecticut has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
13. For the Quarter ending 09/30/2023: Illinois has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
14. For the Quarter ending 09/30/2023: Minnesota has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
15. For the Quarter ending 09/30/2023: Utah has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
16. For the Quarter ending 09/30/2023: Washington has Negative Total Computable Section 6008 Covid 19 Expenditures and Total Federal Share Section 6008 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
17. For the Quarter ending 12/31/2023: Colorado has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
18. For the Quarter ending 12/31/2023: Connecticut has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
19. For the Quarter ending 12/31/2023: Minnesota has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
20. For the Quarter ending 12/31/2023: New Mexico has Negative Total Computable Section 6004 Covid 19 Expenditures and Total Federal Share Section 6004 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.
21. For the Quarter ending 12/31/2023: Hawaii has Negative Total Computable Section 6008 Covid 19 Expenditures and Total Federal Share Section 6008 Covid 19 Expenditures due to the reporting of prior period adjustments during this period.

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

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.

In the fiscal year of 2024, the budget for the Department of Health and Human Services amounted to **** trillion U.S. dollars. In comparison, the Small Business Administration is expected to have a budget of ***** billion U.S. dollars. United States Federal Government The federal government in the United States consists of three branches of the government: the legislative, executive, and judicial branches. The executive branch is the office of the President of the United States, the legislative branch is the United States Congress, and the judicial branch is the United States Supreme Court.The U.S. cabinet belongs to the executive branch of the government, which belongs to the president and vice president. U.S. Department of Health and Human Services The U.S. Department of Health and Human Services is the department of the federal government that provides health services to Americans. The Secretary of the department is Xavier Becerra, who was appointed by current president Joe Biden. Some of the Operating Divisions in this department include the Food and Drug Administration, the Center for Disease Control and Prevention, and the National Institutes of Health. The outlays for the Department of Health and Human Services have been steadily increasing since 2000. The agency that had the highest amount of spending in this department in 2024 was the Centers of Medicare and Medicaid Services.

The United States has the highest expenditure on health care per capita globally. However, the U.S. has an unique way of paying for their health care where a majority of the expenditure falls upon private insurances. In FY 2024, around one ***** of all health expenditure is paid by private insurance. Public insurance programs Medicare and Medicaid accounted for ** and ** percent, respectively, of health expenditure during that same year. U.S. health care system Globally health spending has been increasing among most countries. However, the U.S. has the highest public and private per capita health expenditure among all countries globally, followed by Switzerland. As of 2020, annual health care costs per capita in the United States totaled to over ** thousand U.S. dollars, a significant amount considering the average U.S. personal income is around ** thousand dollars. Out of pocket costs in the U.S. Aside from overall high health care costs for U.S. residents, the total out-of-pocket costs for health care have been on the rise. In recent years, the average per capita out-of-pocket health care payments have exceeded *** thousand dollars. Physician services, dental services and prescription drugs account for the largest proportion of out-of-pocket expenditures for U.S. residents.

Medicaid spent approximately *** billion U.S. dollars on long-term care services in 2023, which was an increase on the previous year. **********, ********, and ********* were the states with the highest long-term care expenditures. States support home- and community-based care Combined spending on nursing care facilities, home health care, and other health care made up roughly one-third of Medicaid’s total costs in 2019. Other health care costs include home- and community-based waiver programs that allow people to receive long-term care at home or in their community. Nearly all states offer the waivers, which can substantially reduce expenditures for Medicaid enrollees who would otherwise have to enter a long-term institutional service, such as a nursing home. In recent decades, the distribution of Medicaid’s long-term care services expenditures has shifted toward home- and community-based care. The costs of in-home care are rising Long-term care expenditures vary depending on the setting, location, and level of care required. In 2020, the annual median cost of long-term care in the United States ranged from ****** U.S. dollars for adult day health care services to ******* U.S. dollars for a private room in a nursing home. In general, the costs of nursing home facilities were considerably higher than those for home care and community living options. However, in-home care reported the highest year-on-year cost increases, and growing demand for the services has led to a rise in spending on home health care over recent years.

In 2020, the share of U.S. federal budget spent on Medicare was 12 percent, a four-times increase since 1970. If current laws stand, the share of federal spending on Medicare could rise to one fifth of total budget by 2051. This statistic shows the share of U.S. federal budget spent on Medicare in 1970, 2020, and forecast for 2051 under current law.