MACPAC Releases Latest Edition of MACStats: Medicaid and CHIP Data Book

New data show Medicaid and CHIP enrollment decreases for second year in a row following the end of the continuous coverage provision

The Medicaid and CHIP Payment and Access Commission (MACPAC) today released the newest edition of the MACStats: Medicaid and CHIP Data Book, with updated data on national and state Medicaid and State Children's Health Insurance Program (CHIP) enrollment, spending, benefits, beneficiaries' health, service use, and access to care. Medicaid and CHIP covered more than 31 percent of the U.S. population in 2024 (Exhibit 1). About 37 percent of children had Medicaid or CHIP coverage in 2024 (Exhibit 2).

As of July 2025, 78.0 million people were enrolled in Medicaid and CHIP. Enrollment decreased by 2.8 percent from July 2024 to July 2025 as states continued to redetermine beneficiaries following the end of the continuous coverage requirement that was attached to the federal medical assistance percentage (FMAP) increase under the Families First Coronavirus Response Act (FFCRA, P.L. 116-127) (Exhibit 11).

MACStats offers the latest data on Medicaid and CHIP, two critical programs that serve as a safety net for low-income individuals who would otherwise lack access to comprehensive health care coverage. These programs also cover services that are frequently not provided by other payers. The data book provides context to help understand how Medicaid and CHIP fit into the broader health care system.

"As Medicaid and CHIP evolve, the MACStats data book continues to deliver invaluable insights into these vital programs that touch the lives of millions," said MACPAC Chair Verlon Johnson. "State and federal policymakers and researchers can use these data to ensure Medicaid and CHIP remain strong and responsive to the people the programs serve."

Although the share of the federal budget devoted to Medicaid and Medicare has grown steadily since the programs were enacted in 1965, in fiscal year (FY) 2024, the share of federal spending on Medicaid and CHIP (9.4 percent) decreased from the prior fiscal year (10.3 percent) due to the expiration of the temporary FMAP increase and the end of the continuous coverage requirement (Exhibit 4). Medicaid spending continues to account for a smaller share of the federal budget in FY 2024 (9.1 percent) than Medicare (12.8 percent) (Exhibit 4).

Total Medicaid spending was $957.4 billion in FY 2024 (Exhibit 16). Spending for CHIP was $28.2 billion (Exhibit 33). The federal share of spending was 64.7 percent of total Medicaid benefit spending in FY 2024, compared with a federal share of 69 percent of total Medicaid benefit spending in FY 2023.

More highlights from this year's edition of MACStats include:

• Spending for people who are dually eligible for Medicaid and Medicare accounted for more than $271 billion in spending in FY 2023 (Exhibit 21).
• More than half of Medicaid spending for enrollees was for capitation payments to managed care plans (Exhibits 17 and 18).
• As in prior years, Medicaid and CHIP enrollees of all ages were more likely to be persons of color and to report fair or poor health than individuals who were covered by private insurance (Exhibit 2).
• Children whose primary coverage source is Medicaid or CHIP are as likely to report seeing a doctor or having a wellness visit within the past year as those with private coverage and more likely than those who are uninsured (Exhibit 40).
• Adults age 19 to 64 whose primary coverage is Medicaid are less likely to report having a usual source of care than those with private coverage and those Medicare coverage (Exhibit 47).

Visit this link for the PDF and spreadsheet versions of MACStats: Medicaid and CHIP Data Book. https://www.macpac.gov/macstats/

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ABOUT MACPAC

The Medicaid and CHIP Payment and Access Commission is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children's Health Insurance Program (CHIP). For more information, please visit: https://www.macpac.gov.