Medicaid is the primary program providing comprehensive health and long-term care to one in five people living in the U.S and accounts for nearly $1 out of every $5 spent on health care. Medicaid is jointly financed by states and the federal government, but states administer Medicaid programs within broad federal rules. Under federal law, Medicaid provides an entitlement to coverage to individuals who are eligible for the program and a guarantee to federal matching dollars for states. State Medicaid policy choices (including the ACA Medicaid expansion, eligibility levels for other populations, reimbursement rates, and delivery system models) as well as other factors such as population demographic characteristics, health needs of Medicaid enrollees, state fiscal capacity, and health care costs affect Medicaid spending. As a result, Medicaid coverage and financing vary significantly across states.
This data collection pulls together metrics that contribute to variation in Medicaid per enrollee spending. It provides data and information on Medicaid program and policy characteristics, and also includes measures of population demographics, health status of Medicaid enrollees, available revenue and state budget choices, and health care costs and access to care that drive demand for Medicaid and affect states’ ability to raise revenue or reduce spending. Restrictions in federal Medicaid spending that are currently being debated in Congress could leave states with tough choices about how to offset reductions through cuts to Medicaid, cuts to other programs, or tax increases. The metrics below can be used to identify states that may be at higher risk if federal Medicaid funding is reduced or if other changes to Medicaid financing are made. For more information on KFF’s analysis of states at risk, see Responding to Federal Medicaid Reductions: Which States Are Most at Risk?
State Characteristics
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Status of State Action on the Medicaid Expansion Decision
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Medicaid Spending per Full-Benefit Enrollee by Enrollment Group
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Total Medicaid Enrollment
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State Medicaid Program and Policy Characteristics
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Medicaid Expansion Enrollment
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Medicaid Expansion Spending
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Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level
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Medicaid and CHIP Income Eligibility Limits for Pregnant Women as a Percent of the Federal Poverty Level
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Medicaid and CHIP Income Eligibility Limits for Children as a Percent of the FPL
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Medicaid Eligibility for SSI Enrollees and Optional Seniors & People with Disabilities Up To 100% FPL
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Total Medicaid MCO Enrollment
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Medicaid Managed Care Penetration Rates by Eligibility Group
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Medicaid Enrollees Using Long-Term Care (LTC) as a Percent of Full-Benefit Medicaid Enrollees
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Distribution of Fee-for-Service Medicaid Spending on Long Term Care
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State Adoption of Key Medicaid Eligibility Pathways Based on Old Age or Disability
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View details about This indicator is not available in Custom State Reports.
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Medicaid-to-Medicare Fee Index
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Population Demographics
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Distribution of Total Population by Federal Poverty Level
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Unemployment Rate (Seasonally Adjusted)
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Projected Growth in the Share of the Population Ages 85+, 2025-2030
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Distribution of Women of Reproductive Age (18-49) by Federal Poverty Level
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Disability Rate of Working-Age Adults
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Health Status of Medicaid Enrollees
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Share of Children with Medicaid/CHIP Who Have Special Health Care Needs
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Disability Prevalence Among People with Medicaid Coverage
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Mental Illness Prevalence by Insurance Coverage
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View details about This indicator is not available in Custom State Reports.
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Medicaid Enrollees Using Long-Term Care (LTC) as a Percent of Full-Benefit Medicaid Enrollees
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Medicaid Enrollees Ages 19-64 by Number of Diagnosed Chronic Conditions
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State Revenue and Budgets
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Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier
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Total State Expenditures by Fund (in millions)
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Total State Expenditures per Capita
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Total Taxable Resources
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State Government Tax Collections per Capita
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Health Care Costs and Access to Care
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Health Care Expenditures per Capita by State of Residence
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Average Annual Family Premium per Enrolled Employee For Employer-Based Health Insurance
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Adults Who Report Not Seeing a Doctor in the Past 12 Months Because of Cost
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Percent of Children (Ages 3-17) Who Faced Difficulties Obtaining Mental Health Care
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Primary Care Health Professional Shortage Areas (HPSAs)
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