Did You Know?

  1. Medicaid serves more than 74 million Americans across the United States.
  2. Medicaid accounts for $1 of every $6 of personal health spending in the U.S.
  3. One in five people with Medicare also rely on Medicaid to cover their healthcare needs – most notably, long-term care services, dental care, vision care and hearing services.
  4. Medicaid benefits include both acute care services and a broad array of long-term care services that Medicare and most private insurance plans do not cover or tightly limit.
  5. Medicaid participation is high. Almost 80 percent of low-income adults with children who are eligible for Medicaid are enrolled, and 93 percent of eligible children participate in Medicaid or CHIP.
  6. More than 35 million children have their health coverage through Medicaid.
  7. Nearly half of all births (42.3%) in the United States are paid for by Medicaid.
  8. Children aging out of foster care are covered by Medicaid until they turn 26.
  9. 56 percent of adults enrolled in Medicaid responded “Always” when asked if they received needed care.
  10. The federal government funds a significant percentage of Medicaid care, ranging from a low of 50% to a high of 77.76%  in Mississippi.
  11. More than two-thirds (69%) of people with Medicaid get their coverage from a private managed care company.
  12. Medicaid finances 25% of all behavioral health care spending and 21% of all spending on SUD services nationally
  13. Two-thirds (66%) of Medicaid spending is attributable to people with disabilities (42.7%) and elderly beneficiaries (23%), many of whom are cared for in nursing homes.
  14. More than 16 million people with Medicaid are living with disabilities or are over age 65.
  15. Medicaid is the largest payer for HIV/AIDS care in the United States.
  16.  Medicaid expansion leads to an estimated 39 to 64 percent reduction in annual mortality rates for older adults gaining coverage.
  17. Eighty-eight percent of Medicaid enrollees reported being somewhat or very satisfied with their doctor, and 91 percent report having a regular source of care.
  18. Adults insured all year with Medicaid coverage reported lower rates of medical bill problems than adults with private coverage and those uninsured during the year
  19. Adults insured all year with Medicaid reported getting cancer screening tests at equal or similar rates to private insurance.
  20. Adults insured all year with Medicaid coverage reported accessing preventive care like blood pressure, cholesterol checks and flu shots at similar or, in the case of flu shots, greater rates than adults with private coverage.
  21. People with Medicaid are significantly less likely to skip services because of the cost of care compared with adults who are uninsured.
  22. Continuously insured adults with Medicaid are more likely to have timely care than those who are uninsured.
  23. Many people with Medicaid work in low-wage jobs for small firms or service industries that typically don’t offer health insurance.  79 percent of workers earning less than 138 percent of the poverty line — the limit to qualify for Medicaid under the expansion — do not get coverage through their employer
  24. More than two thirds of Americans have a friend or family member who has benefited from Medicaid or have received Medicaid benefits themselves.
  25. Numerous studies show that Medicaid has helped make millions of Americans healthier by improving access to preventive and primary care and by protecting against and providing care for serious diseases.
  26. Compared with uninsured children, children with Medicaid are far more likely to have a usual source of care, visit physicians and dentists, and get recommended preventive care, and they are less likely to have unmet needs for medical, dental, and specialty care and prescription drugs.
  27. If all states adopted continuous Medicaid eligibility, 259,000 more kids would have no gaps in coverage.
  28. If all states adopted continuous Medicaid eligibility, 291,000 more kids would have coverage for at least one preventive care visit.
  29. If all states adopted continuous Medicaid eligibility, 81,200 more kids would have no unmet specialty care needs.
  30. Medicaid provides beneficiaries with access to health care services that is comparable to – but less costly than – what they could receive through employer-sponsored insurance.
  31. Medicaid enrollees are just as likely as those with private insurance, and significantly more likely than uninsured adults, to report having a regular source of care.
  32. More than two-thirds (69%) of Americans earning less than $40,000 a year view Medicaid as an important program for their family.
  33. Those with Medicaid report better experiences with their healthcare providers than those who had lacked coverage during the year, and equal experiences to privately insured patients.
  34. Since Medicaid lowers financial barriers to care and limits out-of-pocket costs, Medicaid beneficiaries are much less likely than the uninsured to report unmet health care needs.
  35. Medicaid provides health and long-term coverage to more than 1 in 10 women. For women in particular, the program has served as a critical safety net by providing coverage for a wide spectrum of services that other government programs and private insurance did not, from contraceptives and pregnancy-related care to long-term care services and supports.
  36. Medicaid is a major source of support for specialized providers, including rehabilitation services and assistive technology.
  37. Obtaining access to health care through Medicaid offers long-term benefits. For example, children eligible for Medicaid for more of their childhood earn more as adults and are more likely to attend and complete college.
  38. Adults with Medicaid coverage are significantly less likely than either privately insured or uninsured individuals to report having difficulty paying medical bills.
  39. By filling gaps in coverage among people of color, Medicaid plays a key role in advancing health equity.
  40. Certain groups, such as pregnant women, mandatory eligible children, and individuals receiving hospice care, are exempt from cost-sharing. In addition, services such as emergency services and family planning services are exempt as well.
  41. Medicaid virtually eliminates catastrophic out-of-pocket spending (costs exceeding 30 percent of a person’s income).
  42. Medicaid’s Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) benefits have been a model for care to keep children healthy and treat conditions that could otherwise harm their development.
  43. Medicaid is an active purchaser, using its market leverage to drive improvements in the quality of care provided to patients and to foster more accountable systems of care.
  44. The availability of home and community-based services in Medicaid prevents unnecessary and unwanted institutionalization of people with physical impairments, severe mental illnesses, developmental and intellectual disabilities, and other disabling conditions.
  45. Medicaid has been the principal engine of expanded access to home and community-based services that make independent living and community integration possible for people with disabilities, as well as elderly Americans.
  46. Roughly 80% of nonelderly Medicaid beneficiaries with disabilities who use long-term care services and supports now receive services in the community rather than in institutions.
  47. On a per-person basis, Medicaid spending has been growing more slowly than private insurance premiums and national health spending per capita. Medicaid’s per-person costs grew 2.5 percent between 2007 and 2010, significantly slower than the rate of growth in private insurance and a full point lower than overall medical trends.
  48. People with Medicaid report that their doctor always or often knows their medical history at higher rates than those who are uninsured.
  49. The majority of adult Medicaid recipients work full- or part-time.
  50. Many people with Medicaid work in low-wage jobs for small firms or service industries that typically don’t offer health insurance. 79 percent of workers earning less than 138 percent of the poverty line — the limit to qualify for Medicaid under the expansion — do not get coverage through their employer.
  51. Medicaid is a job creator, especially in rural communities, where it supports vital health care jobs at safety-net hospital, health centers and specialized providers.
  52. Medicaid gives states significant flexibility to design their own programs, including who they cover, what benefits they provide, and how they deliver health care services.
  53. The federal government matches state spending on Medicaid on an open-ended basis to help states respond to the health care needs of their residents.
  54. States can seek federal waivers to test new approaches to operating their Medicaid programs outside of regular federal rules, with federal Medicaid matching funds. Since Medicaid was enacted, every state has been granted at least one waiver and most have been granted several waivers.
  55. Medicaid rules give states the ability to use out of pocket charges to promote the most cost-effective use of prescription drugs.
  56. Under CMS-approved waivers, at least 20 states are now working with private health insurers to provide long-term services.
  57. States have flexibility to charge limited premiums and cost-sharing in Medicaid.
  58. States have taken advantage of Medicaid’s flexibility to improve beneficiary health outcomes while lowering costs. In Vermont, for example, Medicaid reduced unnecessary ER visits by 10 percent by improving care coordination and case management.