US Medicaid Spending, Total · USD bn

## What this measures

Total Medicaid spending in each federal fiscal year (October to September), federal and state money together, in billions of dollars: benefits plus state program administration, for the fifty states, DC and the territories. One value per fiscal year from FY 1974 to FY 2024, dated September 30.

## Why it matters

Medicaid is the largest health program in the country by enrollment and, for most states, the largest single item in the budget once federal funds are counted. Its total sets the scale for every argument about federal matching, cuts and expansion.

## How to read it

FY 2024: $949 billion, +6.1% on FY 2023 and about 88 times the FY 1974 figure ($10.8 billion) in current dollars. For the trend after inflation see us.medicaid.spending_real; for who pays, us.medicaid.federal_spending and us.medicaid.state_spending.

## What it does not say

Nominal dollars, not adjusted for inflation or population. It excludes CHIP-financed coverage, and it excludes Medicaid Fraud Control Units, survey and certification of nursing facilities and the Vaccines for Children program, which MACPAC adds only to the national total in its Exhibit 16. Amounts are net expenditures as states report them on the CMS-64 for federal matching, including adjustments to earlier years, so a year can jump when a large prior-period adjustment lands. Each MACStats edition revises recent years as states revise their reports; Palanor keeps the newest edition's figures. Years before the federal fiscal year moved to October–September have been adjusted by MACPAC to that basis.

## Source

Medicaid and CHIP Payment and Access Commission (MACPAC), MACStats: Medicaid and CHIP Data Book, Exhibit 10 (Medicaid Enrollment and Total Spending Levels and Annual Growth) (https://www.macpac.gov/macstats/; earlier editions at https://www.macpac.gov/publication/macstats-archive/), from MACPAC's analysis of states' CMS-64 Financial Management Report expenditure data. Licence (https://www.macpac.gov/disclaimer/): "Because MACPAC is an agency of the federal government, the information on this site is in the public domain and may be freely copied and distributed. We would appreciate attribution when you cite our information." Read monthly by /api/cron/macpac-sync (src/lib/macpac/medicaid.ts).