Change in total Medicaid spending and enrollment 1998-2024

The number of people enrolled in Medicaid increased by 6.5 percent in 2023, while expenditure increased by 8.3 percent. Due to Medicaid unwinding in 2024 Medicaid enrollment is projected to decline by 8.6 percent, while the spending is expected to grow by 3.4 percent.

Impact of COVID-19 on Medicaid

Approximately 18 percent of Americans were covered by Medicaid in 2020. The total number of Medicaid enrollees continues to increase each year and is projected to surpass 75 million in 2019. A steadily improving economy in the United States is one reason for the slower enrollment growth experienced in recent years. However, unemployment numbers surged due to the COVID-19 pandemic, and Medicaid enrollment is expected to rise over the coming months as millions of people lose their employer-based health insurance.

Medicaid expenditure set to increase

Medicaid expenditure in 2019 was projected to 640 billion U.S. dollars, an increase year on year. Medicaid spending rose by 7.1 percent in 2020, but the economic downturn caused by COVID-19 is likely to significantly increase both state and federal expenditures. More people are now eligible for Medicaid because they have lost income, and the costs of coronavirus testing and treatment are escalating. Many states may not have the budget to pay for it all, especially at a time when tax revenues are declining.