5 Key Facts About Medicaid and Veterans

The One Big Beautiful Bill passed by the House is projected by the Congressional Budget Office to reduce federal Medicaid spending by $793 billion over the next 10 years, a cut that could lead to 10.3 million fewer people enrolled in Medicaid in 2034. The Senate Finance Committee’s draft reconciliation includes similar provisions. Medicaid currently provides health care coverage to 1 in 10 veterans (1.6 million people), and for some, it is their only source of coverage, especially if they do not qualify for military health benefits such as care provided by the Department of Veterans Affairs (VA health care), or TRICARE, the health insurance program administered by the Department of Defense for eligible active-duty service members, retirees, and their families.

The Department of Veterans Affairs operates a nationwide health care system, but access is not guaranteed. Eligibility for VA health care depends on a veteran’s service history, discharge status, income, and whether a health condition is connected to their military service. As a result, about half of veterans are enrolled in VA health care. TRICARE, meanwhile, is generally limited to active-duty members and military retirees.

Medicaid helps fill gaps in coverage for veterans who are low-income, have disabilities, or are otherwise ineligible for military health benefits. Many veterans use Medicaid alongside Medicare or VA health care, particularly as they age and their health needs increase. Veterans enrolled in Medicaid have complex health conditions, including high rates of disability, mental illness, and substance use disorders. Medicaid ensures regular access to care for these veterans, helping them manage chronic conditions, access a broader range of providers outside the VA system, and pay for services not covered by VA health care, such as different forms of long-term care. It also reduces out-of-pocket costs that can pose a barrier to care. This brief presents key facts about veterans enrolled in Medicaid and examines how proposed changes could affect their coverage and access to care.

1. Over the past decade, the number of veterans has declined, but the percent of veterans with Medicaid has increased.

In 2023, there were approximately 16 million veterans ages 19 and older in the United States. The veteran population is both aging and shrinking: nearly half of all veterans are 65 and older, and the total number has declined by 7 million over the past decade, from 23 million in 2013, as older veterans from World War II, the Korean War, and the Vietnam War have passed away, and fewer individuals have entered military service in the recent years.

As the veteran population changes, so too have the pathways to coverage. The Affordable Care Act (ACA) created a new pathway to coverage for veterans who might otherwise have been uninsured by expanding Medicaid eligibility to nearly all adults with incomes up to 138% of the Federal Poverty Level ($21,597 for an individual in 2025). Medicaid expansion covers adults who are parents of dependent children whose income is above the eligibility limit for parent coverage and adults who do not have dependent children and who were previously not eligible for Medicaid. Forty-one states, including DC, have adopted Medicaid expansion, and nearly seven in ten (69%) veterans ages 19 and older who have Medicaid coverage live in a state that has expanded Medicaid.

Since the implementation of Medicaid expansion, the share of veterans with Medicaid, either as their sole source of coverage or in combination with other insurances, has increased, and the share of those who are uninsured has dropped. Between 2013 and 2023, Medicaid enrollment among all veterans increased from 8% to 10% (Figure 1), representing 1.6 million veterans in 2023. However, the share of veterans enrolled in Medicaid varies across states, ranging from as low as 6% to as high as 15% (Appendix Table ). In 2023, 11% of veterans in Medicaid expansion states were enrolled in Medicaid, compared to 9% in non-expansion states. Over the 2013-2023 period, the uninsured rate for veterans fell by more than half, dropping to 2% from 6% (Figure 1). Studies link Medicaid expansion to increased coverage, improved access to care, greater healthcare affordability, and better health .

2. Medicaid often supplements coverage for an aging veteran population.

Among those 1.6 million veterans with Medicaid coverage, most had additional forms of insurance. While some rely on Medicaid as their only source of coverage, it more often supplements other types of insurance by covering services that other payers may not, such as long-term care. For veterans who are also enrolled in Medicare, Medicaid can help cover both premiums and cost-sharing responsibilities, reducing out-of-pocket costs for services like doctor visits, hospital stays, and prescription drugs.

Only 17% of veterans with Medicaid were covered by Medicaid alone. The remaining 83% had at least one other source of coverage. The most common combination was Medicaid and Medicare, which accounted for 60% of all veterans with Medicaid (some of whom were also enrolled in VA health care). This high share reflects the aging veteran population; half of all veterans with Medicaid were 65 and older. Many of today’s veterans served during the Vietnam and Gulf Wars. Smaller percentages of veterans were also enrolled in VA health care (17%), or another other form of insurance coverage, such as TRICARE or employer-sponsored insurance (6%).

3. Veterans with Medicaid have higher disability rates than those who are not covered by Medicaid.

Nearly half (49%) of veterans covered by Medicaid, either as their only source of coverage or in combination with other insurance, report having a disability, compared to fewer than three in ten (29%) veterans who are not covered by Medicaid (Figure 3). A person is considered to have a disability if they experience difficulty with hearing, vision, cognitive function, mobility, self-care, or independent living. While disability rates increase with age among all veterans, the difference in the rates between those with Medicaid and those not covered by Medicaid are especially pronounced in their working-age years. Among veterans ages 27 to 49, 33% of those with Medicaid reported a disability, compared to 17% of those with other coverage. The gap is even wider among veterans ages 50 to 64, with 51% of Medicaid enrollees reporting having a disability compared to 20% of those with other coverage. Veterans 65 and older have the highest disability rates of any age group, but even among this group, a higher percentage of veterans with Medicaid have a disability (55%) compared to those without (40%).

4. Medicaid supports regular access to care for veterans who have high rates of chronic conditions.

Veterans covered by Medicaid often have complex health needs. Nearly half (45%) of veterans with Medicaid describe their health as fair or poor, more than twice the share among those not covered by Medicaid (18%) (Figure 4). All veterans have high rates of chronic conditions (82% for those with Medicaid and 79% for those without), but some conditions are more common among veterans with Medicaid. Specifically, behavioral health conditions affect a larger share of veterans with Medicaid, with 46% reporting any form of mental illness and 26% reporting substance use disorder (SUD), compared to 17% and 13%, respectively, among those without Medicaid. Medicaid provides access to care, including mental health and SUD care for veterans. Among veterans covered by Medicaid, 41% received mental health or SUD treatment in the past year, nearly twice the share of those without Medicaid (21%).

5. Nearly seven in ten working-age veterans with Medicaid are working, but work varies by age, disability, and parental status.

Nearly seven in ten (68%) working-age veterans (ages 19 to 64) enrolled in Medicaid are working, excluding those who receive Supplemental Security Income or Social Security Disability Insurance, or are dually enrolled in Medicare (Figure 5). The share of veterans in this age group varies by state (Appendix Table 2). Veterans who are older (ages 50 to 64), have a disability, or do not have dependent children are less likely to be working:

• The share of veterans who are working declines with age: 79% of those ages 19 to 26 are working, compared to 59% of those ages 50 to 64.
• While 75% of veterans without a disability are working, that share drops to 51% among those with a disability.
• Parents are more likely to be in the workforce than veterans without dependent children (78% vs 60%), likely reflecting their relatively younger age and lower rates of disability.

Proposed changes to Medicaid that would impose work and reporting requirements as a condition of eligibility could negatively affect veterans and lead to coverage loss among those who are unable to work or those unable to report or document work or exemption criteria.

Appendix Tables