Medicaid State Fact Sheets
Published: Sep 27, 2018
Medicaid and the Children’s Health Insurance Program (CHIP) provide health and long-term care coverage to more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities in the United States. Medicaid is a major source of funding for hospitals, community health centers, physicians, and nursing homes. States operate their Medicaid programs within federal standards and a wide range of state options in exchange for federal matching funds. The two-page fact sheets provide a snapshot with key data for Medicaid in every state related to current coverage, access, and spending.
What percentage of people are covered by Medicaid/CHIP in your state? Click on a state or the U.S. to download a fact sheet.
The fact sheets include both state and national level data. Where state-level data was not available, national-level data was used to provide additional context. For specific sources used in the fact sheets, see below.
Total population: State Health Facts. “Total Number of Residents, 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/total-residents/.
Share of population that is low income: State Health Facts. “Distribution of the Total Population by Federal Poverty Level (above and below 200% FPL), 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/population-up-to-200-fpl/.
Share of population covered by Medicaid/CHIP: State Health Facts. “Health Insurance Coverage of the Total Population, 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/total-population/.
State expansion status: State Health Facts. “Status of State Action on the Medicaid Expansion Decision, July 2018.” Kaiser Family Foundation, https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/.
Number of adults in the coverage gap: Rachel Garfield, Anthony Damico, and Kendal Orgera. The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid (Washington, DC: Kaiser Family Foundation, June 2018), https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/.
Number of adults in the expansion group: State Health Facts. “Medicaid Expansion Enrollment, 2016.” Kaiser Family Foundation, https://www.kff.org/health-reform/state-indicator/medicaid-expansion-enrollment/. The estimated adults to gain Medicaid eligibility in Maine and Virginia come from external sources.
- VA: Virginia Office of the Governor. (2018, May 30). Governor Northam Statement on Biennial Budget that Expands Health Care and Invests in a Stronger Economy [Press release]. Retrieved from https://www.governor.virginia.gov/newsroom/all-releases/2018/may/headline-825960-en.html.
- ME: Manatt Health for the Maine Health Access Foundation (MeHAF). MaineCare Expansion: Summary of Estimated Costs and Savings, SFYs 2019-2021 (February 2018), https://legislature.maine.gov/doc/2253.
Uninsured rates: State Health Facts. “Health Insurance Coverage of the Total Population, 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/total-population/.
- Adults ages 19-64: State Health Facts. “Health Insurance Coverage of Adults 19-64, 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/adults-19-64/.
- Children: State Health Facts. “Health Insurance Coverage of Children 0-18, 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/children-0-18/.
- Nursing home residents: State Health Facts. “Distribution of Certified Nursing Facility Residents by Primary Payer Source, 2016.” Kaiser Family Foundation, https://www.kff.org/other/state-indicator/distribution-of-certified-nursing-facilities-by-primary-payer-source/.
- Individuals with disabilities: Kaiser Family Foundation analysis of the 2016 American Community Survey, 1-Year Estimates.
- Medicare beneficiaries:
- U.S. Centers for Medicare & Medicaid Services (CMS). Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and Area of Residence, Calendar Year 2016 (CMS, Office of Enterprise and Data Analytics, Chronic Conditions Data Warehouse, 2016), https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/2016/Downloads/MDCR_ENROLL_AB/2016_CPS_MDCR_ENROLL_AB_42.pdf.
- U.S. Centers for Medicare & Medicaid Services (CMS). Medicare-Medicaid Enrollment (MME): Total Medicare Enrollment: Total, Original Medicare, and Medicare Advantage and Other Health Plan Enrollment and Resident Population, by Area of Residence, Calendar Year 2016 (CMS, Office of Enterprise Data and Analytics, Chronic Conditions Data Warehouse; United States Census Bureau, 2016), https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/2016/Downloads/MDCR_ENROLL_AB/2016_CPS_MDCR_ENROLL_AB_2.pdf.
Share of adult Medicaid enrollees working: Rachel Garfield, Robin Rudowitz, and Anthony Damico. Understanding the Intersection of Medicaid and Work (Washington, DC: Kaiser Family Foundation, January 2018), https://www.kff.org/medicaid/issue-brief/understanding-the-intersection-of-medicaid-and-work/. For more information on which states have approved or pending Section 1115 Medicaid waivers, see the Medicaid Waiver Tracker, including work requirements, at https://www.kff.org/medicaid/issue-brief/which-states-have-approved-and-pending-section-1115-medicaid-waivers/.
Share of children with special health care needs covered by Medicaid: MaryBeth Musumeci and Julia Foutz. Medicaid’s Role for Children with Special Health Care Needs: A Look at Eligibility, Services, and Spending (Washington, DC: Kaiser Family Foundation, February 2018), https://www.kff.org/medicaid/issue-brief/medicaids-role-for-children-with-special-health-care-needs-a-look-at-eligibility-services-and-spending/.
Median eligibility levels:
- 100% of FPL for family of three and individual: U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation. S. Federal Poverty Guidelines Used to Determine Financial Eligibility for Certain Federal Programs (January 2018), https://aspe.hhs.gov/poverty-guidelines.
- Children: State Health Facts. “Medicaid and CHIP Income Eligibility Limits for Children as a Percent of the Federal Poverty Level, 2018.” Kaiser Family Foundation, https://www.kff.org/health-reform/state-indicator/medicaid-and-chip-income-eligibility-limits-for-children-as-a-percent-of-the-federal-poverty-level/.
- Pregnant women: State Health Facts. “Medicaid and CHIP Income Eligibility Limits for Pregnant Women, 2003-2018.” Kaiser Family Foundation, https://www.kff.org/medicaid/state-indicator/medicaid-and-chip-income-eligibility-limits-for-pregnant-women/.
- Parents & Childless adults: State Health Facts. “Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level, 2018.” Kaiser Family Foundation, https://www.kff.org/health-reform/state-indicator/medicaid-income-eligibility-limits-for-adults-as-a-percent-of-the-federal-poverty-level/.
- As of July 2018, Connecticut updated their annual income guidelines, changing eligibility for parents to 155% of FPL. For more information on Connecticut’s annual income guidelines, see: https://www.ct.gov/hh/lib/hh/pdf/HUSKYAnnualIncomeChart.pdf.
- Seniors & people w/ disabilities: Molly O'Malley Watts, Elizabeth Cornachione, and MaryBeth Musumeci. Medicaid Financial Eligibility for Seniors and People with Disabilities in 2015 (Washington, DC, Kaiser Family Foundation, March 2016) adjusted to reflect 2017 SSI Standard and 2017 FPL and updated to reflect state policy changes as of January 1, 2017, https://www.kff.org/medicaid/report/medicaid-financial-eligibility-for-seniors-and-people-with-disabilities-in-2015/.
Medicaid enrollees & expenditures:
- State Health Facts. “Medicaid Spending by Enrollment Group, FY2014.” Kaiser Family Foundation, https://www.kff.org/medicaid/state-indicator/medicaid-spending-by-enrollment-group/.
- State Health Facts. “Medicaid Enrollees by Enrollment Group, FY2014.” Kaiser Family Foundation, https://www.kff.org/medicaid/state-indicator/distribution-of-medicaid-enrollees-by-enrollment-group/.
Medicaid spending by service:
- Note: Values may not sum to 100% due to rounding.
- State Health Facts. “Distribution of Medicaid Spending by Service, FY 2017.” Kaiser Family Foundation, https://www.kff.org/medicaid/state-indicator/distribution-of-medicaid-spending-by-service/.
- For more information on fee-for-service acute care spending, see: https://www.kff.org/medicaid/state-indicator/spending-on-acute-care/.
Nationally Medicaid pays for:
- Health care system: U.S. Centers for Medicare & Medicaid Services (CMS). National Health Expenditure Data Fact Sheet: Historical NHE, 2016 (CMS, April 2018), https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html.
- Safety-net hospitals and health centers: Janet Pagon Sutton, Raynard E. Washington, Kathryn R. Fingar, and Anne Elixhauser. Characteristics of Safety-Net Hospitals, 2014 (Rockville, MD: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Statistical Brief 213, October 2016), https://www.hcup-us.ahrq.gov/reports/statbriefs/sb213-Safety-Net-Hospitals-2014.pdf.
- Long-term care: U.S. Centers for Medicare & Medicaid Services (CMS). National Health Expenditure Data Fact Sheet: Table 15, Nursing Care Facilities and Continuing Care Retirement Communities Expenditures (CMS, April 2018), https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html.
States have flexibility in their Medicaid design: Samantha Artiga, Elizabeth Hinton, Robin Rudowitz, and MaryBeth Musumeci. Current Flexibility in Medicaid: An Overview of Federal Standards and State Options (Washington, DC: Kaiser Family Foundation, January 2017), https://www.kff.org/medicaid/issue-brief/current-flexibility-in-medicaid-an-overview-of-federal-standards-and-state-options/.
National access and satisfaction measures: Kaiser Family Foundation analysis of National Health Interview Survey (NHIS), 2017. Doctor visit among adults refers to a general doctor visit only and does not include specialty care.
Share of those that hold favorable views of Medicaid: Ashley Kirzinger, Bryan Wu, and Mollyann Brodie. Kaiser Health Tracking Poll – February 2018: Health Care and the 2018 Midterms, Attitudes Towards Proposed Changes to Medicaid (San Francisco, CA: Kaiser Family Foundation, March 2018), https://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-february-2018-health-care-2018-midterms-proposed-changes-to-medicaid/.