medicaid-guide.org Presents Medicaid Statistics

The Medicaid program insurers approximately 20 percent of all U.S. citizens. Due to Medicaid’s tremendous influence over low-income Americans, the federal and state governments have allocated billions of dollars for Medicaid services and have increased future Medicaid budgets and spending. Since the program’s conception in 1965, Medicaid has expanded to provide health insurance to over 74 million enrollees, of which about 6 million are enrolled in Children Health Insurance Program (CHIP) as of June in 2017. The inclusion of the Affordable Care Act (ACA) in 2010 significantly increased the amount of funding and the number of citizens receiving Medicaid insurance. Through the ACA, Americans with incomes less than 138 percent of the federal poverty level may now receive Medicaid coverage in states accepting Medicaid expansion policies. Although Medicaid’s impact on the nation may be difficult to determine, the team at medicaid-guide.org knows that statistics might reveal the effectiveness of the Medicaid program.

Medicaid Spending Overview

According to the Centers for Medicare and Medicaid Services (CMS), the combined spending of the federal and state governments for Medicaid amounted to over $550 billion in 2015. From this amount, the federal government sanctioned $350 billion (63 percent) and the states paid about $204 billion (37 percent). Legally, the federal government must pay at least 50 percent of all total expenditures for each state’s Medicaid program.

Due to the ACA eligibility expansion, the 2015 fiscal year experienced the fastest growth the Medicaid program had seen in over a decade. Medicaid spending only increased by 8.1 percent from 2013 to 2014 compared to 9.7 percent from 2014 to 2015. Consequently, Medicaid and Medicare benefits for the federal government has budgeted more than $376.6 billion for the 2017 fiscal year. Between the years 2016 and 2025, Medicaid spending is expected to surpass $806 billion with most (92 percent) of the costs covered by the federal government. However, spending for the end of the 2017 fiscal year was originally anticipated to decline by 4.2 percent because of lowered enrollment due to non-expansion states. Instead, Medicaid legislation has approved budget proposals that will increase National Health Expenditures by $22.2 billion in its efforts to improve access to and quality of services for Medicaid beneficiaries.

Medicaid Expenditures

National Health Expenditures data reveals that national health spending reached $3.2 trillion, or $9,990 per citizen, at the end of 2015 – the most recent year for which data collection results applies. In 2015, the cost for insuring a Medicaid member was about:

  • $3,389 per child.
  • $4,986 per non-newly eligible adult.
  • $6,365 for a newly eligible adult.
  • $14,323 per aged citizen.
  • $19,478 for a disabled adult.

However, the team at medicaid-guide.org reminds Medicaid enrollees that disabled citizens and citizens receiving aid for acute conditions have incurred the most expenditures of any groups covered by Medicaid. Approximately 40 percent of all Medicaid spending is directed to disabled citizens each year, 19 percent to children, 16 percent to older Americans and 26 percent to adult citizens.

In the 2017 Medicaid Report to Congress, the Medicaid and CHIP Payment and Access Commission (MACPAC) reported that about 47.4 percent of all Medicaid benefit spending was used for mandatory medical services while only 21.1 percent was spent on optional services. The remaining funds (31.5 percent) were used on optional services for optional Medicaid enrollees – citizens between eligibility requirements for Medicaid and Medicare services. The team at medicaid-guide.org suggests that these mandatory and optional distinctions help determine how effective each state is at managing expenditures and which health care needs exist in each state.

Medicaid Enrollment

In total, over 74 million Americans are currently enrolled in Medicaid and CHIP. Following the ACA’s execution in 2014, citizen enrollment has increased by 16.7 million citizens, or 29.4 percent, in at least 49 reporting states. Over 38 percent of citizens receiving coverage are newly eligible adults in Medicaid expansion states and over 12 percent in non-expansion states. As of February 2017, even non-expansion states have experienced enrollment increases of 2.5 million Americans, or 12.4 percent from that of 2013. The team at medicaid-guide.org explains that of the total number of citizens enrolled in Medicaid, about 44 percent of citizens are children younger than 18 years of age, 36 percent are adult women and 21 percent are adult men.

Medicaid Projections

The Federal Medical Assistance Percentage, which determines how much the federal government pays for ACA and Medicaid coverage, varies by state. However, the payment rate was 100 percent between the years 2014 and 2016 and is expected to decline to 90 percent after 2020. Currently, the federal government reimburses states 95 percent of their Medicaid costs. Total national spending estimations predict that costs will grow by an average of 5.8 percent after 2018 due to faster Medicaid and Medicare spending as well as inflated enrollee costs. For example, according to the Senate Republican Policy Committee, annual Medicaid spending is projected to reach $957 billion in 2025.

Medicaid enrollment projections for 2025 are estimated to consist of 21 percent previously eligible adults, 17 percent newly eligible adults, nine percent older Americans, 14 percent disabled citizens and 39 percent children. The team at medicaid-guide.org reminds citizens that not all states participated in data collection, so some results may vary.