Total Medicaid federal and state expenditures in the U.S. 1966-2022

In 2022, Medicaid expenditure totaled around 805 billion U.S. dollars, the highest in the provided time interval. The federal government paid approximately 70 percent of total Medicaid expenditures in 2022, with states picking up the other 30 percent. Medicaid’s high-cost enrolleesSpending on aged enrollees and individuals with disabilities accounted for more than half of the total Medicaid expenditure in 2021. One reason why this share is so high is that these groups require greater health care, and often the services are more costly. Spending on long-term care services, which includes nursing facilities and home health care, totaled approximately 154 billion U.S. dollars in 2022. Overall, long-term care services accounted for around 20 percent of all Medicaid expenditure in 2022. The basics of Medicaid fundingMedicaid is a joint federal and state health care plan, and the costs of administering the program are split between the two. States report their Medicaid costs to the federal government on a quarterly basis, and the federal government matches those costs based on a formula. This formula is designed so that the federal government pays a larger share of costs in poorer states, but in general, state costs are matched by the federal government at a 50 percent rate. California was the state with the highest Medicaid costs in 2022.

2022年，美国医疗补助支出总额约为8050亿美元，为所提供时间区间内的最高值。联邦政府在2022年承担了医疗补助总支出的大约70%，其余30%由各州承担。医疗补助的高成本受益者方面，2021年对老年受益者和残疾人士的支出占医疗补助总支出的超过一半。这一比例之所以如此之高，一方面是因为这些群体对医疗保健的需求更大，且往往所需服务成本更高。2022年，长期护理服务（包括护理机构和家庭护理）的支出总额约为1540亿美元。总体而言，长期护理服务在2022年医疗补助总支出中占据了大约20%的比例。医疗补助资金的基本原则在于，医疗补助是一项联邦与州共同承担的医疗保障计划，其管理成本由两者分摊。各州按季度向联邦政府报告其医疗补助成本，联邦政府根据公式进行成本匹配。该公式旨在确保联邦政府在贫困州承担更大的成本份额，但总体而言，州成本由联邦政府以50%的比例进行匹配。加利福尼亚州在2022年承担的医疗补助成本最高。