Medicaid expenditures do not include administrative costs, accounting adjustments, or the U.S. Territories.
Unless otherwise noted, years preceded by "FY" refer to the Federal Fiscal Year, which runs from October 1 through September 30.
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U.S. states with the highest Medicaid expenditure 2024
Total Medicaid spending surpassed 918 billion U.S. dollars in 2024. The state of California had the highest expenditure throughout the year, followed by New York and Texas.Â
The federal government helps poorer states
Both the federal and state governments fund the Medicaid health care program, but at least 50 percent of the costs incurred by states are matched by the federal government. The exact percentage varies by state because the matching rate was designed so that poorer states receive a larger share of program costs from the federal government. The states of Wyoming, South Dakota, and North Dakota spent the least on Medicaid costs in 2021.
Funding share of states set to increase
Under the Affordable Care Act, states have the choice to expand their Medicaid programs to cover nearly all low-income Americans under age 65. For states that implemented the expansion, the federal government paid 100 percent of the state costs for all newly eligible adults from 2014 to 2016. The new matching rate has slowly declined since and reached 90 percent in 2020, which means states have to pick up ten percent of the bill. Governors are concerned about the rise in costs, and state expenditure is projected to increase by 50 percent between 2020 and 2027.
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Kaiser Family Foundation. (September 30, 2025). U.S. states with the highest Medicaid expenditure in FY 2024 (in billion U.S. dollars) [Graph]. In ÌÇÐÄÆƽâ°æ. Retrieved July 26, 2026, from /statistics/245400/total-medicaid-spending-in-the-us-by-state/
Kaiser Family Foundation. "U.S. states with the highest Medicaid expenditure in FY 2024 (in billion U.S. dollars)." Chart. September 30, 2025. ÌÇÐÄÆƽâ°æ. Accessed July 26, 2026. /statistics/245400/total-medicaid-spending-in-the-us-by-state/
Kaiser Family Foundation. (2025). U.S. states with the highest Medicaid expenditure in FY 2024 (in billion U.S. dollars). ÌÇÐÄÆƽâ°æ. ÌÇÐÄÆƽâ°æ Inc.. Accessed: July 26, 2026. /statistics/245400/total-medicaid-spending-in-the-us-by-state/
Kaiser Family Foundation. "U.S. States with The Highest Medicaid Expenditure in Fy 2024 (in Billion U.S. Dollars)." ÌÇÐÄÆƽâ°æ, ÌÇÐÄÆƽâ°æ Inc., 30 Sep 2025, /statistics/245400/total-medicaid-spending-in-the-us-by-state/
Kaiser Family Foundation, U.S. states with the highest Medicaid expenditure in FY 2024 (in billion U.S. dollars) ÌÇÐÄÆƽâ°æ, /statistics/245400/total-medicaid-spending-in-the-us-by-state/ (last visited July 26, 2026)
U.S. states with the highest Medicaid expenditure in FY 2024 (in billion U.S. dollars) [Graph], Kaiser Family Foundation, September 30, 2025. [Online]. Available: /statistics/245400/total-medicaid-spending-in-the-us-by-state/
