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Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2024. After near continuous increase in Medicaid enrollment, especially during the pandemic, 2024 recorded the first deline in the number of enrollees. This is due to the ending of the COVID-19 continuous enrollment provision in April 2023. Since the 'unwinding', enrollees continue to decrease, but as of Spetember 2025 still stands higher than pre-pandemic figures.

Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare.

From the beginning to Obamacare

Medicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2024. 

Who is enrolled in Medicaid?

Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for ** percent of total enrollment, were responsible for ** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.