Spending
In fiscal year (FY) 2023, total Medicaid spending was $900.3 billion. Of this amount, $619.9 billion was federal spending and $280.4 billion was state spending. This represents 18 percent of U.S. health care spending (2022) and 10.3 percent of federal outlays (FY 2023). 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
Mandatory and Optional Enrollment and Spending in Medicaid
March 5, 2026
Federal statute and regulations mandate coverage of certain populations and benefits and define optional populations and services that states may cover in their Medicaid programs. States design their programs within federal requirements to meet specific needs and priorities. In this session, we presented our analysis of enrollment and spending for mandatory and optional enrollees and […]
Spending and Utilization for Medicaid Home- and Community-Based Services
July 24, 2025
Medicaid home- and community-based services (HCBS) are designed to allow people with long-term services and supports (LTSS) needs to live in their homes or a home-like setting in the community. In this brief, we focus on HCBS users and expenditures. This analysis found that, nationally, the number of Medicaid beneficiaries using HCBS increased while the number of institutional LTSS […]
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 […]