Entity: Medicaid
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Medicaid

31 Facts
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People without lawful immigration status are ineligible for federal programs such as SNAP, the Health Insurance Marketplace, and Medicaid.
November 18, 2025 high eligibility
Federal statutory or regulatory eligibility rules for certain benefits.
About 24 million people who do not have health insurance through an employer or a public program such as Medicaid use the Affordable Care Act (ACA) marketplace to buy health plans.
November 06, 2025 high statistic
The ACA marketplace provides a route for individuals without employer-sponsored or public insurance to purchase subsidized health coverage.
Medicaid, a joint federal-state health program, serves nearly one in four rural Americans.
November 06, 2025 high statistic
Baseline statistic about Medicaid coverage in rural areas.
States face nearly $1 trillion in projected Medicaid spending reductions over the decade following 2025.
November 06, 2025 high projection
Projected aggregate Medicaid spending reductions affecting states over the next decade.
In 2025, the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services proposed rules that would prohibit federal Medicaid reimbursement for gender-affirming medical care for patients under age 18, prohibit Children's Health Insurance Program (CHIP) reimbursement for patients under age 19, and block Medicaid and Medicare funding for services at hospitals that provide pediatric gender-affirming care.
October 30, 2025 high temporal
Federal-level regulatory proposals affecting reimbursement and funding for pediatric gender-affirming care.
In 2025, about 24 million people who did not have employer-sponsored insurance or Medicaid used the Affordable Care Act (ACA) marketplaces to purchase health insurance.
October 30, 2025 high temporal
Baseline statistic on ACA marketplace enrollment for people without employer coverage or Medicaid.
U.S. Medicaid has a statutory "best price" protection that requires Medicaid to receive the lowest price charged to any U.S. commercial payer.
October 11, 2025 high policy
Medicaid reimbursement rules include a statutory mechanism intended to secure the lowest U.S. commercial price for Medicaid programs.
Medicaid beneficiaries typically do not pay out-of-pocket for their prescription medications.
October 11, 2025 high observation
Medicaid program design generally minimizes direct medication costs for enrolled patients.
Most-favored-nation pricing for drugs sold to Medicaid links Medicaid reimbursement prices to the lower prices paid for the same drugs in other developed countries.
October 10, 2025 high policy
Description of a pricing policy mechanism that ties domestic public payer prices to international prices.
Medicaid and Medicaid beneficiaries generally pay some of the lowest prices for prescription drugs in the United States compared with other payer types.
October 10, 2025 high economics
Comparative statement about relative drug prices across different payer types in the U.S. health system.
About 24 million Americans who do not have job-based or public insurance, such as Medicaid, rely on Affordable Care Act marketplaces to purchase health coverage.
October 09, 2025 high statistical
Scope of people using ACA (Obamacare) insurance marketplaces in the United States.
People who are in the United States illegally are generally ineligible to enroll in Medicaid or Medicare and are not eligible to purchase health insurance through the Affordable Care Act marketplace.
October 07, 2025 high policy
Federal eligibility rules for major public insurance programs and the ACA marketplace.
Hospitals are legally required to provide emergency medical treatment regardless of a patient's ability to pay or immigration status, and Emergency Medicaid can reimburse hospitals for emergency care provided to immigrants who would have been eligible for Medicaid if not for their immigration status.
October 07, 2025 high process
Mechanism by which emergency care for uninsured or unauthorized immigrants can be funded.
Federal emergency payments for emergency care, including Emergency Medicaid reimbursements, constitute less than 1% of total Medicaid spending.
October 07, 2025 high statistical
Share of Medicaid spending accounted for by emergency-related federal payments.
As of 2025, about 24 million people who do not have employer-based insurance or coverage through public programs such as Medicaid use the Affordable Care Act (ACA) marketplaces to buy health plans.
October 06, 2025 high temporal
Scale of enrollment in ACA marketplaces among people without employer or public program coverage.
Medicaid is a government health insurance program for people with low incomes or disabilities and is funded jointly by state and federal governments.
October 05, 2025 high descriptive
Defines the nature and funding structure of Medicaid.
Medicaid spending is typically one of the largest components of U.S. state budgets.
October 05, 2025 high budget
Describes the relative size of Medicaid in state budgetary expenditures.
U.S. federal rules prohibit undocumented immigrants from receiving federal funds for health coverage through Medicare, Medicaid, and the Affordable Care Act's premium tax credits (as of 2025-10-05).
October 05, 2025 high policy
Federal eligibility rules determine which populations may receive federal health program funds.
Congressional reconciliation is a legislative procedure used to advance budget-related bills and can be used to pursue deficit reduction, modify tax credits, and change entitlement programs such as Medicaid.
October 05, 2025 high procedural
Reconciliation is commonly employed to enact fiscal and entitlement changes that are tied to the budget process.
A 2025 Public Religion Research Institute (PRRI) American Values Survey of 5,543 U.S. adults found 62% said the country was going in the wrong direction, with 92% of Democrats, 71% of independents, and 24% of Republicans saying the country was going in the wrong direction.
September 08, 2025 high temporal
National public‑opinion poll measuring perceptions of national direction, reported by PRRI in 2025.
As of June 2025, 70.5 million people were enrolled in Medicaid in the United States, according to the Centers for Medicare & Medicaid Services (CMS).
June 01, 2025 high temporal
Baseline enrollment statistic for the Medicaid program.
The U.S. Department of Health and Human Services and the U.S. Department of Agriculture update the Dietary Guidelines for Americans every five years.
high temporal
Describes the statutory update cycle for the federal dietary guidance.
Medicaid is a joint federal-state U.S. health insurance program that provides health coverage to eligible low-income individuals and families, including many children.
high definition
Provides a general definition of the Medicaid program referenced in policy debates about healthcare funding.
Expiration of Affordable Care Act-related tax provisions can lead to higher health insurance premiums, and cuts to Medicaid funding can result in people losing health coverage.
medium policy_effect
Describes common policy effects cited in debates over health-care-related budget provisions.
U.S. federal law prohibits undocumented immigrants from obtaining Medicaid benefits.
high legal
Medicaid is a federal program with eligibility rules that exclude undocumented noncitizens from standard Medicaid coverage.
The tax-and-spending law enacted under President Trump's administration was projected to reduce federal Medicaid spending on rural health care by $137 billion over a 10-year period.
high temporal
Projection of a multi-year reduction in federal Medicaid spending for rural health attributed to the cited tax-and-spending legislation.
U.S. federal law prohibits individuals who are not lawfully present in the United States from enrolling in Medicaid.
high legal
Medicaid eligibility restrictions under federal law.
Some U.S. states use legal mechanisms or program designs to provide Medicaid-funded healthcare benefits to non-citizens who are not lawfully present despite federal restrictions on Medicaid enrollment for undocumented immigrants.
high policy
State-level variations in implementation of Medicaid-funded benefits for non-citizens.
The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for administering the Medicaid program.
high organizational
CMS oversees federal administration of Medicaid and Medicare programs.
Federal legislation can prohibit Planned Parenthood from receiving Medicaid funds for clinical services, including abortion services, mammograms, Pap tests, contraception, and sexually transmitted infection testing.
high policy
Describes the scope of federal funding restrictions that can be applied to Planned Parenthood under spending or appropriations legislation.
U.S. Medicare and Medicaid programs cover drugs that the U.S. Food and Drug Administration has approved for treatment of Type 2 diabetes.
high policy
Federal health insurance programs provide coverage for FDA-approved Type 2 diabetes medications.