- 17 Laura Snyder et al.,Why Does Medicaid Spending VaryVary across States: A Chart Book of Factors Driving State Spending (Washington: Kaiser Family Foundation, 2012), accessed Feb. 19, 2014, http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8378.pdf.
- 18 Alemayehu Bishaw,Poverty: 2010 and 2011, American Community Survey Briefs (Washington: U.S. Census Bureau, 2012), accessed Jan. 16, 2014, http://www.census.gov/prod/2012pubs/acsbr11-01.pdf.
- 19 Kaiser Commission on Medicaid and the Uninsured,Where Are States Today? Medicaid and CHIP Eligibility Levels for Children and Non- Disabled Adults (Washington: Kaiser Family Foundation, 2013), accessed Jan. 16, 2014, http://kaiserfamilyfoundation.files.wordpress.com/2013/04/7993-03.pdf.
- 20 Ibid.
- 21 Ibid.
- 22 Centers for Medicare & Medicaid Services, "Affordable Care Act," accessed Feb. 11, 2014, http://www.medicaid.gov/AffordableCareAct/Affordable-Care-Act.html; and Kaiser Family Foundation's State Health Facts, "Status of State Action on the Medicaid Expansion Decision, 2014," Data source: Centers for Medicare & Medicaid Services and Kaiser Commission for Medicaid and the Uninsured, accessed April 16, 2014, http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/.
For state-by-state data please see the tables below.
Enrollment In Medicaid
Medicaid covers more than 20 percent of Americans over the course of the year. Enrollment varies across states because of factors such as poverty rates, state decisions to expand coverage above federal minimums, and the reach of employer-sponsored health insurance.17
In 2010, states with the highest percentage of residents below the FPL—New Mexico, Mississippi, and the District of Columbia—also were among those with the highest percentage of residents enrolled in Medicaid.18 Other states with high Medicaid enrollment rates provided at least limited Medicaid coverage to individuals above federal requirements.197 California's Medicaid program, for example, covers only family planning services for 1.8 million people otherwise ineligible for Medicaid.20 Vermont provides full Medicaid benefits to nondisabled adults at a level substantially above the federal minimum requirement.21
The percentage of state residents covered by Medicaid will increase dramatically starting this year in states that expand their Medicaid eligibility through the Affordable Care Act.22
Medicaid enrollment and uninsured rates
2010
For state-by-state data please see the tables below.
Comparing Medicaid enrollment trends with other health insurance coverage
The proportion of Americans covered by employer-sponsored health insurance decreased between 2000 and 2012, with declines particularly pronounced during economic downturns. In contrast, enrollment in Medicaid and Medicare increased during those times, as did the percentage of uninsured Americans. Although actual Medicaid enrollment data are available only through 2010, U.S. Census Bureau survey estimates show that Medicaid enrollment continued to rise in 2011 but leveled off in 2012.23
Medicaid enrollment increased 50 percent over the last decade, from 44 million to 66 million people. This growth is one of the major drivers of the program's increases in spending over this time.24 Growth occurred again under the Affordable Care Act. Medicaid enrollment started to increase in 2014, especially in states that expanded their programs to cover previously ineligible low-income childless adults.25
- 23 U.S. Census Bureau, "Health Insurance Coverage Status and Type of Coverage by State, All Persons: 1999 to 2012," Current Population Survey, Annual Social and Economic Supplements, Health Insurance Historical Tables, table HIB-4, accessed Jan. 9, 2013, http://www. census.gov/hhes/www/hlthins/data/historical/HIB_tables.html.
- 24 Katherine Young et al., Enrollment-Driven Expenditure Growth: Medicaid Spending During the Economic Downturn, Fy 2007-2011 (Washington: Kaiser Family Foundation, 2013), accessed Jan. 14, 2014, http://kaiserfamilyfoundation.files.wordpress.com/2013/05/8309-02.pdf.
- 25 Congressional Budget Office,Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision (Washington: Congressional Budget Office, 2012), accessed Jan. 16, 2014, http://www.cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pd.