May 9, 2017

Medicaid by the Numbers

  • Medicaid was created as a safety net for the most vulnerable in American society – today it covers about 20 percent of the U.S. population.
  • Spending continues to increase and is projected to reach $957 billion a year in 2025.
  • Under Obamacare’s expansion of the program, Washington pays much more to care for able-bodied, nonelderly adults than it does for the traditional Medicaid population. 

The Medicaid program has exploded in terms of both enrollment and spending since its creation in 1965, with Obamacare funneling millions more into the already broken program. As the New York Times noted on March 27: “It has grown gradually into a behemoth that provides for the medical needs of one in five Americans … starting for many in the womb, and for others, ending only when they go to their graves.”

The House health care bill reforms Obamacare’s expansion of Medicaid and includes structural changes for the program. Medicaid was not working well before Obamacare, with beneficiaries often facing issues accessing health care. Surveys have found that nearly one out of three doctors would not accept new Medicaid patients. The health care law made things worse by funneling millions of additional people into it.


According to the 2016 annual report by the Centers for Medicare and Medicaid Services, the federal government and the states spent a total of $554 billion for Medicaid in 2015, the latest year for which data is available. Of this amount, the federal government paid $350 billion, about 63 percent of the total, and the states paid $204 billion, about 37 percent.



Medicaid enrollment is ever-increasing, growing from 46 million people in 2005 to 70 million in 2015. Obamacare added 9 million newly eligible adults to the program in 2015 alone. If Obamacare remains law, enrollment is expected to increase even further, reaching 82 million enrollees in 2025. 

Enrollment Growth

enrollment and Spending by group

Spending in Medicaid varies widely among the different groups covered by the program. In 2015, children accounted for 41 percent of people covered by the program, and only 19 percent of the expenditures, an average of $3,389 per child in the program. The disabled were 16 percent of the people enrolled in Medicaid, and 40 percent of expenditures; an average of $19,478 per person.

Estimated Medicaid

Enrollment by population category

Prior to Obamacare, adults eligible for Medicaid coverage were generally low-income pregnant women and parents with dependent children. Obamacare expanded eligibility for Medicaid to nearly all adults earning less than 138 percent of the federal poverty level, dramatically changing the makeup of the program. In the past, children were the biggest group of Medicaid enrollees. Under Obamacare, adults – non-newly eligible and newly eligible together – will almost equal the child population in Medicaid by 2025.

Medicaid Enrollees

Obamacare’s inherent inequity

The federal government’s payment rate – the Federal Medical Assistance Percentage – for the traditional Medicaid population varies by state. It averages about 59 percent across all states and the District of Columbia this year. However, for Obamacare’s newly eligible population of non-elderly, able-bodied adults, states receive a much higher payment rate from Washington. The Obamacare payment rate started at 100 percent from 2014 to 2016, gradually declining to 90 percent in 2020 and after. This year, Washington reimburses states 95 percent of their costs for the Obamacare population but still only an average of 59 percent for all other Medicaid enrollees. 


Issue Tag: Health Care