Medicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic

Appendix Table 1: Total Medicaid Enrollment, FY 2019 (In Thousands)
State Expansion Status Total Enrollment Traditional Group Expansion Group Expansion Group (%)
United States 75,176 59,829 15,347 28%2
Alabama Not Adopted 1,035 1,035 N/A N/A
Alaska Adopted 207 156 51 25%
Arizona Adopted 1,880 1,453 427 23%
Arkansas Adopted 872 603 269 31%
California Adopted 12,875 9,073 3,802 30%
Colorado Adopted 1,289 879 410 32%
Connecticut Adopted 955 688 268 28%
Delaware Adopted 219 157 63 29%
District of Columbia Adopted 261 152 109 42%
Florida Not Adopted 3,879 3,879 N/A N/A
Georgia Not Adopted 1,966 1,966 N/A N/A
Hawaii Adopted 317 204 114 36%
Idaho1 Not Adopted 304 304 N/A N/A
Illinois Adopted 2,750 2,046 704 26%
Indiana Adopted 1,336 1,023 313 23%
Iowa Adopted 607 434 173 29%
Kansas Not Adopted 374 374 N/A N/A
Kentucky Adopted 1,299 848 452 35%
Louisiana Adopted 1,679 1,171 509 30%
Maine Adopted 270 242 28 11%
Maryland Adopted 1,229 918 311 25%
Massachusetts Adopted 1,765 1,419 346 20%
Michigan Adopted 2,443 1,739 704 29%
Minnesota Adopted 1,098 895 202 18%
Mississippi Not Adopted 675 675 N/A N/A
Missouri1 Not Adopted 917 917 N/A N/A
Montana Adopted 260 160 100 38%
Nebraska1 Not Adopted 246 246 N/A N/A
Nevada Adopted 600 386 214 36%
New Hampshire Adopted 186 131 55 30%
New Jersey Adopted 1,668 1,116 552 33%
New Mexico Adopted 838 580 258 31%
New York Adopted 6,156 4,239 1,917 31%
North Carolina Not Adopted 2,182 2,182 N/A N/A
North Dakota Adopted 93 72 20 22%
Ohio Adopted 2,901 2,315 586 20%
Oklahoma1 Not Adopted 653 653 N/A N/A
Oregon Adopted 967 499 468 48%
Pennsylvania Adopted 2,869 2,093 776 27%
Rhode Island Adopted 309 239 70 22%
South Carolina Not Adopted 1,270 1,270 N/A N/A
South Dakota Not Adopted 105 105 N/A N/A
Tennessee Not Adopted 1,586 1,586 N/A N/A
Texas Not Adopted 4,255 4,255 N/A N/A
Utah1 Not Adopted 293 293 N/A N/A
Vermont Adopted 174 116 58 33%
Virginia Adopted 1,532 1,247 284 19%
Washington Adopted 1,760 1,190 570 32%
West Virginia Adopted 532 369 163 31%
Wisconsin Not Adopted 1,183 1,183 N/A N/A
Wyoming Not Adopted 58 58 N/A N/A
NOTES: Totals may not sum due to rounding. 1. Idaho, Missouri, Nebraska, Oklahoma, and Utah have adopted Medicaid expansion due to successful ballots measures but have either implemented or plan to implement the expansion after FY 2019. 2. Percent of expansion group for United States is based on total enrollment in expansion states only. Expansion group enrollment is 20% in all states and DC.
SOURCE: KFF Analysis of Medicaid Budget and Expenditure System (MBES) enrollment reports as of June 2020 and FMR net expenditure data as of September 2020.
Appendix Table 2: Total Medicaid Expenditures, FY 2019 (In Millions)
State Expansion Status Total Expenditures Traditional Group Expansion Group Expansion Group (%)
United States 594,570 500,793 93,777 21%2
Alabama Not Adopted 5,880 5,880 N/A N/A
Alaska Adopted 2,096 1,649 448 21%
Arizona Adopted 13,168 9,939 3,229 25%
Arkansas Adopted 6,843 5,071 1,772 26%
California Adopted 87,856 67,855 20,001 23%
Colorado Adopted 9,202 7,532 1,669 18%
Connecticut Adopted 8,168 5,996 2,172 27%
Delaware Adopted 2,246 1,782 463 21%
District of Columbia Adopted 2,892 2,452 440 15%
Florida Not Adopted 24,384 24,384 N/A N/A
Georgia Not Adopted 10,852 10,852 N/A N/A
Hawaii Adopted 2,178 1,609 569 26%
Idaho1 Not Adopted 2,143 2,143 N/A N/A
Illinois Adopted 18,470 12,814 5,656 31%
Indiana Adopted 12,439 9,954 2,486 20%
Iowa Adopted 5,200 4,157 1,042 20%
Kansas Not Adopted 3,602 3,602 N/A N/A
Kentucky Adopted 10,208 7,218 2,989 29%
Louisiana Adopted 11,642 8,504 3,138 27%
Maine Adopted 2,867 2,748 119 4%
Maryland Adopted 11,730 9,011 2,719 23%
Massachusetts Adopted 17,413 15,202 2,211 13%
Michigan Adopted 18,258 13,787 4,471 24%
Minnesota Adopted 12,721 10,876 1,845 15%
Mississippi Not Adopted 5,507 5,507 N/A N/A
Missouri1 Not Adopted 10,535 10,535 N/A N/A
Montana Adopted 1,858 1,140 718 39%
Nebraska1 Not Adopted 2,142 2,142 N/A N/A
Nevada Adopted 3,979 2,697 1,282 32%
New Hampshire Adopted 1,985 1,730 255 13%
New Jersey Adopted 15,909 12,615 3,293 21%
New Mexico Adopted 5,263 3,793 1,470 28%
New York Adopted 58,094 48,331 9,763 17%
North Carolina Not Adopted 13,596 13,596 N/A N/A
North Dakota Adopted 1,164 912 252 22%
Ohio Adopted 23,466 19,456 4,010 17%
Oklahoma1 Not Adopted 4,760 4,760 N/A N/A
Oregon Adopted 9,427 6,447 2,980 32%
Pennsylvania Adopted 32,080 27,379 4,700 15%
Rhode Island Adopted 2,586 2,144 442 17%
South Carolina Not Adopted 6,306 6,306 N/A N/A
South Dakota Not Adopted 899 899 N/A N/A
Tennessee Not Adopted 10,092 10,092 N/A N/A
Texas Not Adopted 40,026 40,026 N/A N/A
Utah1 Not Adopted 2,724 2,724 N/A N/A
Vermont Adopted 1,638 1,410 228 14%
Virginia Adopted 11,307 9,713 1,594 14%
Washington Adopted 13,128 8,709 4,420 34%
West Virginia Adopted 3,926 2,994 932 24%
Wisconsin Not Adopted 9,133 9,133 N/A N/A
Wyoming Not Adopted 584 584 N/A N/A
NOTES: Totals may not sum due to rounding. 1. Idaho, Missouri, Nebraska, Oklahoma, and Utah have adopted Medicaid expansion due to successful ballots measures but have either implemented or plan to implement the expansion after FY 2019. 2. Percent of expansion group for United States is based on total expenditures in expansion states only. Expansion group expenditures are 16% of total spending in all states and DC.
SOURCE: KFF Analysis of Medicaid Budget and Expenditure System (MBES) enrollment reports as of June 2020 and FMR net expenditure data as of September 2020.
Appendix Table 3: Spending per Enrollee, FY 2019
State Expansion Status Total Spending per Enrollee Traditional Group Expansion Group
United States 7,910 8,370 6,1102
Alabama Not Adopted 5,680 5,680 N/A
Alaska Adopted 10,110 10,570 8,720
Arizona Adopted 7,000 6,840 7,560
Arkansas Adopted 7,850 8,410 6,580
California Adopted 6,820 7,480 5,260
Colorado Adopted 7,140 8,570 4,080
Connecticut Adopted 8,550 8,720 8,110
Delaware Adopted 10,230 11,390 7,370
District of Columbia Adopted 11,070 16,110 4,040
Florida Not Adopted 6,290 6,290 N/A
Georgia Not Adopted 5,520 5,520 N/A
Hawaii Adopted 6,870 7,900 5,010
Idaho1 Not Adopted 7,050 7,050 N/A
Illinois Adopted 6,720 6,260 8,030
Indiana Adopted 9,310 9,730 7,940
Iowa Adopted 8,570 9,590 6,020
Kansas Not Adopted 9,620 9,620 N/A
Kentucky Adopted 7,860 8,520 6,620
Louisiana Adopted 6,930 7,260 6,170
Maine2 Adopted 10,620 11,380 4,170
Maryland Adopted 9,540 9,810 8,740
Massachusetts Adopted 9,870 10,720 6,390
Michigan Adopted 7,470 7,930 6,350
Minnesota Adopted 11,590 12,150 9,110
Mississippi Not Adopted 8,160 8,160 N/A
Missouri1 Not Adopted 11,490 11,490 N/A
Montana Adopted 7,150 7,130 7,190
Nebraska1 Not Adopted 8,720 8,720 N/A
Nevada Adopted 6,630 6,990 5,980
New Hampshire Adopted 10,670 13,250 4,590
New Jersey Adopted 9,540 11,310 5,970
New Mexico Adopted 6,280 6,540 5,690
New York Adopted 9,440 11,400 5,090
North Carolina Not Adopted 6,230 6,230 N/A
North Dakota Adopted 12,580 12,640 12,330
Ohio Adopted 8,090 8,410 6,840
Oklahoma1 Not Adopted 7,290 7,290 N/A
Oregon Adopted 9,750 12,920 6,360
Pennsylvania Adopted 11,180 13,080 6,060
Rhode Island Adopted 8,370 8,950 6,360
South Carolina Not Adopted 4,970 4,970 N/A
South Dakota Not Adopted 8,590 8,590 N/A
Tennessee Not Adopted 6,360 6,360 N/A
Texas Not Adopted 9,410 9,410 N/A
Utah1 Not Adopted 9,300 9,300 N/A
Vermont Adopted 9,410 12,110 3,950
Virginia2 Adopted 7,380 7,790 5,600
Washington Adopted 7,460 7,320 7,760
West Virginia Adopted 7,380 8,110 5,720
Wisconsin Not Adopted 7,720 7,720 N/A
Wyoming Not Adopted 10,060 10,060 N/A
NOTES: Totals may not sum due to rounding. 1. Idaho, Missouri, Nebraska, Oklahoma, and Utah have adopted Medicaid expansion due to successful ballots measures but have either implemented or plan to implement the expansion after FY 2019. 2. Due to Virginia and Maine implementing expansion in January 2019 (although Maine allowed for retroactive enrollment as early as July 2018), estimates of spending per enrollee for the expansion group are likely an underestimate.
SOURCE: KFF Analysis of Medicaid Budget and Expenditure System (MBES) enrollment reports as of June 2020 and FMR net expenditure data as of September 2020.
Issue Brief

KFF Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KFF | twitter.com/kff

The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.