How many people in the U.S. are on Medicaid?
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Medicaid covers more Americans than any other single health insurance program in the country. As of late 2025, about 68.8 million people were enrolled in Medicaid, with another 7.2 million covered through the Children's Health Insurance Program (CHIP)—a related program that extends coverage to children in families who earn too much to qualify for Medicaid. Together, that's roughly 76 million people, or about one in five Americans.
Medicaid is run jointly by the federal government and each individual state. The federal government sets the ground rules and helps fund it. States then run their own programs within those guidelines. That arrangement means eligibility rules, covered services, and the share of residents enrolled can look quite different depending on where you live.
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Who is enrolled in Medicaid?#who-is-enrolled-in-medicaid
Medicaid was designed to cover people who wouldn't otherwise be able to afford health care. That includes a wide range of people across different stages of life and circumstances.
In Washington, D.C. and the 49 states where complete age data is available, children account for about 48% of enrollment (35.5 million) and adults make up the remaining 52% (38.9 million).
Older adults and people with disabilities represent a relatively small slice of the overall enrollee population, but they account for more than half of all Medicaid spending. That's because this group often requires intensive, ongoing care—including long-term services that other types of insurance rarely cover. Medicaid foots the bill for 60% of all nursing home residents in the country, for example.
Medicaid also covers more than 40% of all births in the U.S., including close to half of all births in rural communities. It's the main way many families can access prenatal and postpartum care.
Some people are guaranteed coverage under federal law, regardless of which state they live in:
- Children through age 18 in families earning below 138% of the federal poverty level, which is $37,702 for a family of three in 2026
- Pregnant people with income below 138% of the federal poverty level
- Most adults age 65 and older, as well as people with disabilities, who receive cash assistance through the Supplemental Security Income (SSI) program
Some states have extended coverage to others, including:
- Seniors and people with disabilities who don't receive SSI but have income below the poverty level
- People whose medical bills are high enough to bring their effective income below the state's eligibility threshold—such as someone paying out of pocket for nursing home care
- Non-disabled adults under 65 with income below 138% of the federal poverty level, which is $22,025 for a single person in 2026
- People with higher incomes who need long-term care
What percentage of the population in each state is on Medicaid?#what-percentage-of-the-population-in-each-state-is-on-medicaid
Because each state shapes its own program, enrollment rates vary significantly from one place to the next.
In 2024, Louisiana enrolled the highest share of its residents—44% of the state's population was on Medicaid. Utah was on the other end of the spectrum at 10%. The national average came in at about 26%, meaning roughly one in four Americans was covered by Medicaid at some point during the year.
In terms of raw numbers, California has more Medicaid enrollees than any other state, with over 12.6 million people covered. New York, Texas, Florida, and Illinois also have some of the largest enrolled populations in the country.
How many people on Medicaid work?#how-many-people-on-medicaid-work
Across the board, Medicaid-enrolled working-age adults without disabilities are overwhelmingly in the workforce or engaged in caregiving, education, or managing a health condition. Among Medicaid-enrolled adults under 65 who don't receive disability benefits and aren't also covered by Medicare, 92% are either employed or have a clear reason they're not working. Nearly two-thirds work full or part-time. Of the rest, 12% are out of the workforce to care for a child or family member, 10% are dealing with a health condition or disability that prevents them from working, and 7% are in school.
Only about 8% of the unemployed group—those who are retired, currently searching for work, or not working for other unspecified reasons—fall outside those categories.
How many people are on Medicaid and Medicare?#how-many-people-are-on-medicaid-and-medicare
Medicaid and Medicare are separate programs that serve different purposes. Medicare is a federal program that provides health coverage to people 65 and older, as well as to some younger people with certain disabilities. It's not income-based. Medicaid, by contrast, is designed for people with lower incomes and is administered differently in every state. When someone qualifies for both, they're known as " dual eligibles."
In 2025, roughly 12 million low-income seniors and people with disabilities were enrolled in both programs at once. For this group, the two programs work in tandem—Medicare typically handles hospital stays, doctor visits, and prescription drugs, while Medicaid helps cover costs that Medicare leaves behind, like premiums, deductibles, and long-term care services.
Dual-eligible enrollees are a small portion of the overall Medicaid population, but they tend to have more complex health needs than the average enrollee in either program.
How many children are on Medicaid?#how-many-children-are-on-medicaid
When it comes to health coverage for kids, no program does more than Medicaid and CHIP combined. Together, they cover close to half of all children in the U.S.
As of late 2025, approximately 36.7 million children were enrolled in Medicaid or CHIP. Medicaid alone accounts for coverage of roughly 40% of all children in the country.
Because Medicaid finances more than 40% of all deliveries in the U.S.—and nearly half in rural areas—the program is often there from a child's very first day of life. It's also a primary source of prenatal care for low-income mothers, which shapes health outcomes well beyond delivery.
Children covered by Medicaid have access to a particularly comprehensive set of benefits under a federal requirement called Early and Periodic Screening, Diagnosis and Treatment (EPSDT). Under this rule, states must cover any service that's medically necessary for someone under 21—even if that same service isn't available to adults in the state's plan. That protection makes Medicaid one of the most complete coverage options available for children, regardless of where they live.
