Medicaid is financed through a partnership between the federal government and the states, with the federal government matching state spending at a rate known as the Federal Medical Assistance Percentage, or FMAP. In 2007, federal and state spending on Medicaid totaled $319 billion, with the federal government spending 57 percent and state governments contributing 43 percent (Tables 7 & 8).
- Densely populated states spend significantly more money on Medicaid than smaller states, ranging from $433 million in Wyoming to $44 billion in New York. While differences in population account for some of this variation, payments per enrollee also vary widely by state.
- The FMAP rate varies by state based on the state’s per capita income relative to the national average. The minimum FMAP rate is 50% in wealthier states, and in relatively poorer states, primarily in the South, the FMAP is higher, reaching 76% in Mississippi.
- The American Recovery and Reinvestment Act (ARRA) provided a temporary FMAP increase through calendar year 2010 to help support state Medicaid programs. Enhanced FMAP rates for FY 2010 average 68% and range from 62% in ten states to 85% in Mississippi.
- In FY 2008, on average, 16 percent of state general fund expenditures were appropriated to the Medicaid program. States in the South appropriated smaller shares of their general fund to Medicaid compared to states in other regions.
- Nationally, Medicaid represents over 20 percent of all state expenditures but there is substantial variation among states.
- Nationally, Medicaid spends over $5,100 per enrollee, ranging from $3,200 in California to over $8,000 in Rhode Island and New York.
View related interactive table on statehealthfacts.org
