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Change in total Medicaid spending and enrollment 1998-2021

The number of people enrolled in Medicaid dropped by 1.7 percent between 2018 and 2019 – states had also reported declines in enrollment over the previous twelve-month period. Medicaid expenditure increased by 6.3 percent in 2020, although spending grew at a slower pace.

Impact of COVID-19 on Medicaid

Approximately 18 percent of Americans were covered by Medicaid in 2018. The total number of Medicaid enrollees continues to increase each year and surpassed 70 million for the first time in 2016. A steadily improving economy in the United States is one reason for the slower enrollment growth experienced in recent years. However, unemployment numbers surged due to the COVID-19 pandemic, and Medicaid enrollment is expected to rise over the coming months as millions of people lose their employer-based health insurance.

Medicaid expenditure set to increase

Medicaid expenditure totaled 600 billion U.S. dollars in 2017 and has continued to grow in the years since. It was projected that spending would rise by 6.2 percent in 2020, but the economic downturn caused by COVID-19 is likely to significantly increase both state and federal expenditures. More people are now eligible for Medicaid because they have lost income, and the costs of coronavirus testing and treatment are escalating. Many states may not have the budget to pay for it all, especially at a time when tax revenues are declining.

Change in total Medicaid spending and enrollment from 1998 to 2021

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Release date

October 2020


United States

Survey time period

fiscal years 1998 to 2020

Supplementary notes

Enrollment percentage changes from June to June of each year. Spending growth percentages in state fiscal year.
* Projected.

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Statistics on "Medicaid/CHIP"

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