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What is the spending on Medicaid?


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In FY 2026 the federal government and the states spent $1,026 billion on Medicaid.

Of the $1,026 billion total, the federal government contributed $715 billion and the states kicked in $-714 billion.

Medicaid Spending Analysis

This page shows the current trends in Medicaid spending. Sourcing of Medicaid breakdown here.There are also charts on Medicaid spending history. See here for a general history of entitlement spending.

Recent Medicaid Spending

Recent Medicaid Spending

Chart S.21t: Recent Medicaid Spending

Medicaid spending increased steadily from $325 billion in 2007 to nearly $500 billion in 2014. But then, with the implementation of the Patient Protection and Affordable Care Act of 2010, Medicaid began a three year rapid increase to $542 billion in 2015. Starting with the COVID year of 2020 Medicaid spending increased from $615 billion in 2019 to $838 billion in 2023.

In 2026 Medicaid spending was $1,026 billion.

Recent Medicaid Spend as Pct GDP

Chart S.22t: Recent Medicaid Spend as Pct GDP


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Viewed from a GDP perspective, Medicaid spending increased from 2.25 percent GDP in 2007 to 2.65 percent of GDP in 2010 in the aftermath of the Great Recession. In 2014-15 Medicaid spending jumped up to 3 percent of GDP and has remained at about 3 percent of GDP into the 2020s.

In 2026 Medicaid spending was 0.0 percent GDP.

US Medicaid Spending Since 1965

Medicaid benefits cost about 3 percent of GDP each year.

Medicaid Spending since 1965

Chart S.23t: Medicaid Spending since 1965


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Medicaid, the joint federal/state health care program for the poor, was passed in 1965. Benefits began in 1966 and rapidly climbed to over 0.5 percent of GDP by 1971, before slowly flattening out to 1 percent of GDP in the late 1980s.

Starting in the 1990s Medicaid began a rapid increase in cost, hitting 1.5 percent of GDP in 1991, and 1.9 percent in 1995. In the recession of 2000-1 Medicaid spending took another bump up to 2.4 percent GDP in 2004, then up to 2.6 percent GDP after the Great Recession of 2006-08.

When the Patient Protection and Affordable Care of 2010 Act kicked in in the mid 2010s, Medicaid spending bumped up to 3 percent of GDP. In the COVID crisis of 2020 Medicaid bumped up to 3.3 percent GDP. In 2026 Medicaid spending was 0.0 percent GDP.

US Medicaid Shares Between Feds and States

The federal government picks up about 2/3 of the cost of Medicaid.

Medicaid Shares since 1965

Chart S.24t: Medicaid Shares since 1965


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Medicaid, the joint federal/state health care program for the poor, was advertised as a 50-50 program, with 50 percent paid for by the federal government and 50 percent paid for by the states. This held until about 1990 when the federal share started increasing. By 2018, after the implementation of the PPACA Act, the federal share was 1.89 percent of GDP and the state share was 1 percent GDP.

In 2026 the federal Medicaid share was estimated at 2.34 percent GDP. and the state share was -2.34 percent GDP.

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Spending Data Sources

Spending data is from official government sources.

Gross Domestic Product data comes from US Bureau of Economic Analysis and measuringworth.com.

Detailed table of spending data sources here.
Medicare breakdown here; Medicaid breakdown here.

Federal spending data begins in 1792.

State and local spending data begins in 1820.

State and local spending data for individual states begins in 1957.

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Data Sources for 2022_2031:

Sources for 2022:

GDP, GO: GDP, GO Sources
Federal: Fed. Budget: Hist. Tables 3.2, 5.1, 7.1
State and Local: State and Local Gov. Finances
'Guesstimated' by projecting the latest change in reported spending forward to future years

Sources for 2031:

GDP, GO: GDP, GO Sources
Federal: Fed. Budget: Hist. Tables 3.2, 5.1, 7.1
State and Local: State and Local Gov. Finances
'Guesstimated' by projecting the latest change in reported spending forward to future years

> data sources for other years
> data update schedule.

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US Budget Deficit, Receipts, Outlays for FY 2026

On October 15, 2026, the US Treasury reported in its Monthly Treasury Statement (and xlsx) for September that the federal deficit for FY 2025 ending September 30, 2026, was $1,99 billion. Here are the numbers, including total receipts, total outlays, and deficit compared with the numbers projected in the FY 2026 federal budget published in February 2025:

Federal Finances
FY 2026 Outcomes
Budget
billions
Outcome
billions
Receipts $5,873    $5,403
Outlays$7,419$7,396
Deficit$1,547$1,993

The Monthly Treasury Statement includes "Table 4: Receipts of the United States Government, September 2026 and Other Periods." This table of receipts by source is used for usgovernmentspending.com to post details of federal receipt actuals for FY 2025. usdgovernmentspending.com obtains the data for outlays and receipts from apis at fiscaldata.treasury.gov.


This MTS report on FY 2026 actuals is a problem for usgovernmentspending.com because this site uses Historical Table 3.2--Outlays by Function and Subfunction from the Budget of the United States as its basic source for federal subfunction outlays. But the Monthly Treasury Statement only includes "Table 9. Summary of Receipts by Source, and Outlays by Function of the U.S. Government, September 2025 and Other Periods". Subfunction amounts don't get reported until the FY28 budget in February 2027. Until then usgovernmentspending.com estimates actual outlays by "subfunction" for FY 2026 by factoring subfunction budgeted amounts for FY26 by the ratio between relevant actual and budgeted "function" amounts where actual outlays by subfunction cannot be gleaned from the Monthly Treasury Statement.

Final detailed FY 2026 actuals will not appear on usgovernmentspending.com until the FY 2028 federal budget is published in February 2027 with the actual outlays for FY 2026* in Historical Table 3.2--Outlays by Function and Subfunction.
State and Local Finances for 2024
On August 7, 2026 we updated the state and local spending and revenue for FY 2024 using the new Census Bureau ...

State and Local Finances for 2024 -- First Look
On July 2, 2026 we updated the state and local spending and revenue for FY 2024 using the new Census Bureau S ...

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