US Medicaid State Spending · USD bn

## What this measures

Medicaid spending paid with state funds in each federal fiscal year, in billions of dollars: benefits and state program administration across the states, DC and the territories. One value per fiscal year, FY 2010 to FY 2024; the federal share is us.medicaid.federal_spending, and the two add up to the total.

## Why it matters

Medicaid is jointly financed: the federal government matches each state's spending at its federal medical assistance percentage (FMAP), higher for poorer states and for the Affordable Care Act expansion group. The split decides who carries the cost of growth and of any federal change to the match.

## How to read it

FY 2024: $337 billion (FY 2010: $132 billion). In FY 2024 the federal government paid 64.5% of the total ($612 billion federal, $337 billion state); see us.medicaid.federal_share.

## What it does not say

"State" includes local government contributions and provider taxes that states use to fund their share. Each fiscal year comes from the one MACStats edition that published it (Exhibit 16 covers a single year), using the figures states had reported a few months after the year closed; Exhibit 10, revised in every edition, can differ for the same year by up to 0.5% of the total. Covers the fifty states, DC and the territories (MACPAC's "Subtotal (states and territories)"); federal spending in the territories is capped, but territories report their full spending, so the federal amount can overstate what was actually paid them. Excludes CHIP, Medicaid Fraud Control Units, survey and certification and Vaccines for Children.

## Source

Medicaid and CHIP Payment and Access Commission (MACPAC), MACStats: Medicaid and CHIP Data Book, Exhibit 16 (Medicaid Spending by State, Category, and Source of Funds; Table 6 in editions before 2015) (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).