According to Medicaid Statistics, Medicaid is a joint federal and state program in the United States that provides health coverage to low-income individuals and families, including children, pregnant women, adults, seniors, and people with disabilities. It is the largest source of health coverage in the country, Serving millions of Americans.
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- Medicaid and CHIP enrollment numbers from March 2023 showed that 93,876,834 people were enrolled across 50 states and D.C.
- As of May 2022, approximately 12.6 million California residents had enrolled in Medicaid health insurance programs – comprising roughly 14% of the 89.4 million nationwide enrollees (89 million).
- As of April, there were 86,714,574 individuals enrolled.
- 7,162,260 individuals were enrolled in CHIP.
- The total Medicaid expenditure was about $616.1 billion in 2022.
- The federal expenditures in 2018 were about $386 billion in 2022.
- The state expenditure was about $229.6 billion.
- From 2018-2027, expenditures are anticipated to increase at an annual average rate of 5.3% and reach $1,0007.9 billion by 2027.
- The United States has the highest expenditure on healthcare per capita globally. Medicaid accounted for 19% of health expenditure in 2022.
- Estimates suggest that over time, the federal government will cover approximately 60% of total Medicaid costs; states will cover 40%.
- About 17.8% of Americans were covered by 2020, and 18.9% in 2021.
Medicaid Enrollment Statistics by State
- California: Approximately 12 million.
- New York: Approximately 7 million.
- Texas: Approximately 4.5 million.
- Florida: Approximately 4.2 million.
- Pennsylvania: Approximately 3 million
- Ohio: Approximately 3 million
- Illinois: Approximately 2.8 million
- Michigan: Approximately 2.7 million
- North Carolina: Approximately 2.5 million
- Georgia: Approximately 2.4 million
Medicaid Enrolment Statistics by Eligibility Group
- Children: Approximately 36 million children were enrolled.
- Adults: The number of adults enrolled in Medicaid varies based on eligibility criteria and state-specific factors. As of the most recent data available, there were approximately 27 million adults enrolled.
- Individuals with disabilities: Approximately 10 million individuals with disabilities were enrolled in Medicaid.
- Seniors: There were approximately 8 million seniors enrolled.
- Pregnant women: Around 2 million pregnant women were enrolled.
Medicaid Expenditures Statistics by State
- California: In 2021, California’s total Medicaid expenditures amounted to $116.8 billion.
- New York: New York’s total expenditures reached $77.2 billion in 2021.
- Texas: Total expenditures in Texas for 2021 were approximately $72.6 billion.
- Florida: Florida’s total expenditures amounted to $29.7 billion in 2021.
- Pennsylvania: In 2021, Pennsylvania’s total Medicaid expenditures were around $30.8 billion.
- Ohio: Total expenditures in Ohio for 2021 reached $28.3 billion.
- Illinois: Illinois reported total expenditures of $28.6 billion in 2021.
- Michigan: Michigan’s total expenditures amounted to $26.3 billion in 2021.
- North Carolina: Total Medicaid expenditures in North Carolina for 2021 were approximately $18.8 billion.
- Georgia: Georgia reported total expenditures of $15.1 billion in 2021.
Age Distribution of Medicaid Beneficiaries
- Children: In 2020, approximately 40% of beneficiaries were children under the age of 18.
- Adults: Adults aged 19 to 64 accounted for about 29% of enrollees in 2020.
- Elderly: In 2020, individuals aged 65 and older constituted around 12% of beneficiaries.
- Disabled: Approximately 14% of beneficiaries in 2020 were individuals with disabilities.
- Dual Eligible: Dual eligible, who qualify for both Medicaid and Medicare, represent a significant portion of beneficiaries. In 2020, they accounted for about 15% of enrollment.
Medicaid and Long-Term Care
- In 2021, Medicaid financed approximately 51% of all nursing home care expenditures in the United States.
- As of 2021, over 4.6 million individuals received long-term care services and support through Medicaid’s Home and Community-Based Services (HCBS) waivers.
- HCBS spending accounted for about 57% of long-term care spending in 2021.
- In 2021, total spending on long-term care services was approximately $177 billion.
- Medicaid’s share of total national long-term care spending was about 37% in 2021.
Fraud and Abuse
- The estimated amount of fraud in the United States ranges from $19 billion to $65 billion annually.
- In fiscal year 2020, the Medicaid Fraud Control Units (MFCUs) obtained 1,423 criminal convictions related to fraud and abuse.
- In the same year, MFCUs initiated 1,136 civil cases and 1,275 administrative actions related to fraud and abuse.
- Medicaid fraud investigations resulted in the recovery of over $2.6 billion in fiscal year 2020.
- Approximately 10% of payments are estimated to be improper, resulting from fraud, waste, or abuse.
- The estimated percentage of fraudulent payments within the program ranges from 3% to 10%.
Medicaid and the Affordable Care Act (ACA)
- Before the Affordable Care Act (ACA) was introduced, around 50 million Americans, or one out of every six, did not have health insurance.
- The United States spent almost 17% of its GDP on healthcare, the highest among developed countries.
- In comparison, Australia’s healthcare spending was around 9% of GDP, and Germany’s was around 11%.
- Surveys conducted in 2008 showed that over 80% of Americans were in favor of an overhaul of the healthcare system.
- As of 2021, approximately 31 million individuals have gained healthcare coverage through ACA-related enrollment in programs such as Medicaid or insurance purchased from the Marketplace.
- One study estimated that during the four years after 29 states expanded Medicaid, approximately 19.2 thousand lives were saved from treatable conditions like heart disease and diabetes.
- Opponents of the ACA spent around $420 million on TV ads to portray the law negatively.
- Supporters of the ACA spent only $27 million supporting the law.
