Medicaid’s Expanding Enrollment

The Medicaid program spends close to $1 trillion annually, with about 65% of that coming fom the federal government and the rest from state governnments. This is almost, but not quite, one-in-five dollars of total US health care spending. Medicaid is not quite as big as Medicare, which is about $1.2 trillion per year, but Medicaid alone is almost one-in-five dollars of total US health care spending. James Hamlette and Karen Kopecky offer a check check-in on the Medicaid program in “Who’s Driving Medicaid’s Enrollment Growth?” (Economic Commentary: Federal Reserve Bank of Cleveland, October 13, 2026). As they write about Medicaid: [I]t finances primary and acute medical care and long-term care for eligible low-income individuals. The criteria for eligibility have changed over time, and today, eligible populations span a wide range, including children, pregnant women, low-income elderly and disabled individuals, and working adults in low-wage jobs. The program is jointly administered…