Spending
In fiscal year (FY) 2018, total Medicaid spending was $621 billion. Of this amount, $391 billion was federal spending and $230 billion was state spending. This represents 16.7 percent of U.S. health care spending (2017) and 9.5 percent of federal outlays (FY 2018). Medicaid pays for approximately 42 percent of all long-term services and supports in the U.S., and approximately 24 percent of mental health and substance use disorder services.
Go to our MACStats data book for the most recent detailed data on spending including trends and information broken out by state and eligibility group.
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Featured Publications
State Options to Address Medicaid Spending Growth
April 10, 2025
The federal government and the states share responsibility for financing Medicaid. States receive federal matching funds for allowable state expenditures on an open-ended basis. As state spending increases or decreases, so does federal spending. When states experience circumstances such as unexpected variation in economic conditions on the health system and changes to federal policy, Medicaid’s […]
High-Cost Drugs and the Medicaid Program: MACPAC Evidence and Recommendations
February 6, 2024
While Medicaid drug spending is growing, it is increasingly driven by high-cost specialty drugs. In fiscal year (FY) 2021, Medicaid spent approximately $80.6 billion on outpatient prescription drugs and collected $42.5 billion in rebates, bringing net drug spending to $38.1 billion. In FY 2021, drugs over $1,000 per claim accounted for less than 2 percent […]
Highlights from MACStats 2023
December 14, 2023
The MACStats: Medicaid and CHIP Data Book compiles the most current data available on Medicaid and the State Children’s Health Insurance Program (CHIP) into a single, end-of-year publication. The data book contains statistics on Medicaid and CHIP enrollment and spending and key aspects of both programs, including federal matching rates, eligibility levels, and access to care measures, […]