An official website of the United States Government -

MACPAC Releases New 2016 Edition of MACStats Medicaid and CHIP Data Book

New compilation of MACStats offers latest statistics and trends on spending, enrollment, and access to care

Today, the Medicaid and CHIP Payment and Access Commission (MACPAC) released the December 2016 edition of the MACStats: Medicaid and CHIP Data Book, the Commission’s annual update of national and state-specific data for Medicaid and the State Children’s Health Insurance Program (CHIP), including enrollment and spending, eligibility levels across states, and beneficiaries’ health, service use, and access to care. Medicaid and CHIP cover more than one-quarter of the U.S. population who otherwise would have no health insurance.

The 2016 edition of MACStats compiles data on Medicaid and CHIP that policymakers need to understand how Medicaid and CHIP operate at the federal and state levels. These statistics, which MACPAC regularly updates on, come from multiple sources and are often difficult to find.

“MACStats contains a veritable trove of information for state and federal policymakers, reporters, researchers, and anyone looking for greater clarity on the significant role that Medicaid and CHIP play in the lives of approximately 90 million people, as well as the roles of these programs within the broader health care system,” said MACPAC chair Sara Rosenbaum. “At a time when Medicaid policy will be the subject of important debates, both in Washington and in state capitals, MACStats provides useful statistics to inform those deliberations.”

This year’s edition of MACStats contains statistics showing that:

  • Medicaid and CHIP together accounted for 16.8 percent of national health expenditures in 2014, Medicare accounted for 20.4 percent, and private insurance accounted for 32.7 percent.
  • Looking at the state-funded portion of state budgets, states spent about 15.3 percent of their state budgets on Medicaid in state fiscal year 2014, a smaller share than they spent on elementary and secondary education (24.1 percent).
  • After experiencing high enrollment growth in 2014 and 2015, Medicaid and CHIP enrollment grew less than 1 percent in 2016.
  • Nearly half (45.9 percent) of all individuals enrolled in Medicaid in 2015 had family incomes below 100 percent of the federal poverty level (FPL); nearly two-thirds (63.8 percent) had incomes below 138 percent FPL.
  • In fiscal year 2013, individuals eligible on the basis of disability and those age 65 and older accounted for about one-quarter of Medicaid enrollees, but about two-thirds of program spending.
  • Drug rebates in Medicaid cut net drug spending in Medicaid almost by half (45.3 percent) in fiscal year 2015.
  • Adults whose primary coverage source was Medicaid or CHIP in 2015 reported having a usual source of care at a similar rate as those with private insurance; children whose primary source of coverage was Medicaid or CHIP were reported as seeing a general doctor or having a well-child checkup at rates similar to children with private insurance.

MACStats is divided into six sections that include:

  • Medicaid and CHIP enrollment and spending compared to other payers, with detail on Medicaid’s share of federal and state budgets;
  • trends in Medicaid and CHIP enrollment and spending;
  • state-level Medicaid and CHIP enrollment and spending, including data on Medicaid spending per enrollee, supplemental payments to hospitals and other providers, prescription drug payments and rebates, and other key items;
  • state-level Medicaid and CHIP eligibility thresholds for children, pregnant women, non-aged and non-disabled adults, as well as people with disabilities and those age 65 or older;
  • measures of beneficiary health, use of services, and access to care; and
  • a technical guide describing the data sources used in MACStats and the methods that MACPAC uses to analyze these data.

MACPAC is required to review national and state-specific Medicaid and CHIP data as part of its statutory mandate under Title XIX of the Social Security Act. MACPAC publishes these data in a single source and online throughout the year as soon as they become available.

Visit this link for the PDF and online versions of the December 2016 MACStats: Medicaid and CHIP Data Book. Visit for new issue briefs on access to care for adults with Medicaid coverage and new information on state 1115 demonstration waivers expanding Medicaid to the new adult group. Follow us on Twitter @macpacgov.



The Medicaid and CHIP Payment and Access Commission is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and CHIP. For more information, please visit: