Medicaid & CHIP
This category provides information about the states health coverage programs for the low-income, including Medicaid and the Children's Health Insurance Program (CHIP). Includes topics such as enrollment, eligibility requirements, managed care participation, spending and federal matching amounts, and enrollment practices.
Select a subcategory on the left to see how the indicators compare across the states. Results will be shown as a table, map, or trend graph as available.
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categories & subcategories
Medicaid & CHIP Indicators
Medicaid Spending
- Total Medicaid Spending
- Distribution of Medicaid Spending by Service
- Distribution of Medicaid Spending on Acute Care
- Distribution of Medicaid Spending on Long Term Care
- Average Annual Growth in Medicaid Spending, FY1990 – FY2010
- Distribution of Medicaid Payments by Enrollment Group
- Medicaid Payments per Enrollee
- Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier
- Federal and State Share of Medicaid Spending
- Federal Medicaid Disproportionate Share Hospital (DSH) Allotments
Medicaid Budget Actions
Medicaid Physician Fees
Medicaid Beneficiaries
- Total Medicaid Enrollment
- Medicaid Enrollment as a Percent of Total Population
- Distribution of Medicaid Enrollees by Enrollment Group
- Medicaid Enrollment by Gender
- Monthly Medicaid Enrollment (in thousands)
- Percent Change in Medicaid Enrollment- June
- Percent Change in Medicaid Enrollment- December
- Monthly Medicaid Enrollment for Children (in thousands)
- Percent Change in Enrollment of Children in Medicaid
- Monthly Medicaid Enrollment for Adults (in thousands)
- Percent Change in Monthly Enrollment of Adults in Medicaid
- Trends in Medicaid Enrollment (in thousands)- June
- Trends in Medicaid Enrollment (in thousands)- December
Children's Medicaid and CHIP Eligibility
- Income Eligibility Limits for Children’s Regular Medicaid and Children’s CHIP-funded Medicaid Expansions as a Percent of Federal Poverty Level (FPL), January 2013
- Income Eligibility Limits for Children’s Regular Medicaid and Children’s CHIP-funded Medicaid Expansions by Annual Income, January 2013
- Income Eligibility Limits for Children’s Separate CHIP Programs by Annual Incomes and as a Percent of Federal Poverty Level, January 2013
Medicaid/CHIP Eligibility
SSI Beneficiaries
- Total Supplemental Security Income (SSI) Beneficiaries
- Total Supplemental Security Income (SSI) Beneficiaries as a Percent of Population
- Distribution of Supplemental Security Income (SSI) Beneficiaries by Age
- Aged Supplemental Security Income (SSI) Beneficiaries
- Aged Supplemental Security Income (SSI) Beneficiaries as a Percent of Population Ages 65+
- Supplemental Security Income (SSI) Beneficiaries with Disabilities
- Supplemental Security Income (SSI) Beneficiaries with Disabilities as a Percent of Population
Medicaid Medically Needy
- Medicaid Medically Needy Program Enrollment
- Medicaid Medically Needy Enrollees by Eligibility Category
- Medicaid Medically Needy Program Spending (in Millions)
- Medicaid Medically Needy Program Spending by Eligibility Category (in Millions)
- Medicaid Medically Needy Program per Enrollee Spending
- Medicaid Medically Needy Program Spending per Enrollee by Eligibility Category
Medicaid Managed Care
- Medicaid Managed Care Enrollees
- Medicaid Managed Care Enrollees as a Percent of State Medicaid Enrollees
- Medicaid Enrollment in Managed Care by Plan Type
- Comprehensive Medicaid Managed Care Models in Operation
- Comprehensive Medicaid Managed Care Organization Acute Care Benefit Carve-Outs
- Providers Recognized as Primary Care Providers (PCPs) in Managed Care Organizations
- Providers Recognized as Primary Care Providers (PCPs) in Primary Care Case Management (PCCM) Programs
- Initiatives to Improve Comprehensive Medicaid Managed Care Quality and Care Coordination
- Comprehensive Medicaid Managed Care Activity for Dual Eligibles
- Medicaid MCOs and Medical Loss Ratio (MLR) Requirements, October 2010
Births Financed by Medicaid
Medicaid/CHIP Eligibility Systems
Application & Enrollment Practices
- Has Eliminated Face-To-Face Interviews for Children’s Medicaid and CHIP Enrollment
- No Asset Tests Required (Or Asset Test Limit) for Children’s Medicaid and CHIP
- State Has Express Lane Eligibility for Children in Medicaid and CHIP
- Has Presumptive Eligibility for Children in Medicaid and CHIP
- Length of Time a Child is Required to be Uninsured Prior to Enrolling in Children’s Health Coverage
- Use of Telephone and Online Application Forms in Medicaid and Children’s Health Insurance Program (CHIP)
- Out-Stationed State Eligibility Workers
Enrollment Practices for Pregnant Women
Renewal Practices
Premiums and Co-Payments for Children
- Premium, Enrollment Fee, and Copayment Requirements for Children, January 2013
- Premium Payments and Enrollment Fees for Children at Selected Income Levels, January 2013
- Co-payment Amounts for Selected Services for Children at Selected Income Levels, January 2013
- Disenrollment Policies for Non-Payment of Premiums in Children’s Coverage, January 2013
CHIP
- Total CHIP Expenditures
- Number of Children Ever Enrolled in the Children’s Health Insurance Program (CHIP)
- Monthly CHIP Enrollment
- Percent Change in Monthly CHIP Enrollment- June
- Percent Change in Monthly CHIP Enrollment- December
- Trends in Monthly CHIP Enrollment- June
- Trends in Monthly CHIP Enrollment- December
- Estimated Number of Children Enrolled in CHIP with Family Income at or Below 200% Federal Poverty Level (FPL) and Above 200% FPL
- CHIP Program Name and Type
- Enhanced Federal Medical Assistance Percentage (FMAP) for the Children’s Health Insurance Program (CHIP)
- Projected Federal CHIP Allotments, Under Current Law and Under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA 2009) (dollars in millions)
Home and Community-Based Services
- Total Number of Medicaid 1915(c) Home and Community-Based Service Waivers
- Medicaid 1915(c) Home and Community-Based Service Waiver Participants, by Type of Waiver
- Medicaid 1915(c) Home and Community-Based Service Waiver Expenditures (in thousands), by Type of Waiver
- Total Number of Aged and Aged/Disabled Medicaid 1915(c) HCBS Waiver Participants
- Total Aged and Aged/Disabled Medicaid 1915(c) HCBS Waiver Expenditures
- Waiting Lists for Medicaid 1915(c) Home and Community-Based (HCBS) Waivers
- Medicaid Home Health Participants
- Medicaid Home Health Expenditures
- Medicaid Personal Care Services Participants
- Medicaid Personal Care Services Expenditures
- Money Follows the Person Grant Awardees
Medicaid Coverage of Preventive Services
Medicaid Benefits
Institutional and Clinic Services
- Medicaid Benefits: Clinic Services, by an organized facility or clinic not part of a hospital – Freestanding Ambulatory Surgery Center
- Medicaid Benefits: Clinic Services, by an organized facility or clinic not part of a hospital – Public Health and Mental Health Clinics
- Medicaid Benefits: Federally Qualified Health Center Services
- Medicaid Benefits: Inpatient Hospital Services, other than in an Institution for Mental Diseases
- Medicaid Benefits: Outpatient Hospital Services
- Medicaid Benefits: Rehabilitation Services – Mental Health and Substance Abuse
- Medicaid Benefits: Rural Health Clinic Services
Practitioner Services
- Medicaid Benefits: Certified Registered Nurse Anesthetist Services
- Medicaid Benefits: Chiropractor Services
- Medicaid Benefits: Dental Services
- Medicaid Benefits: Medical/Surgical Services of a Dentist
- Medicaid Benefits: Nurse Midwife Services
- Medicaid Benefits: Nurse Practitioner Services
- Medicaid Benefits: Optometrist Services
- Medicaid Benefits: Physician Services
- Medicaid Benefits: Podiatrist Services
- Medicaid Benefits: Psychologist Services
Prescription Drugs
Physical Therapy and Other Services
Products and Devices
Transportation Services
Other Services
Long-Term Care: Home and Community Based Care
- Medicaid Benefits: Home and Community-Based Services Waiver
- Medicaid Benefits: Home Health Services, includes nursing services, home health aides, and medical supplies/equipment
- Medicaid Benefits: Hospice Care
- Medicaid Benefits: Personal Care Services
- Medicaid Benefits: Private Duty Nursing Services
- Medicaid Benefits: Program of All-Inclusive Care for the Elderly
Long-Term Care: Institutional Care
- Medicaid Benefits: Inpatient Hospital, Nursing Facility and Intermediate Care Facility Services In Institutions for Mental Diseases, age 65 and older
- Medicaid Benefits: Inpatient Psychiatric Services, under age 21
- Medicaid Benefits: Intermediate Care Facility Services for Individuals with Intellectual Disabilities
- Medicaid Benefits: Nursing Facility Services, other than in an Institution for Mental Diseases
- Medicaid Benefits: Religious Non-Medical Health Care Institution and Practitioner Services
data collection
Medicaid Benefits
This data collection reflects Medicaid benefits covered in each state, limitations applied to those benefits, cost-sharing charges, and the reimbursement methodologies used for those benefits as of October 1, 2010. Data for four additional points in time (January 1, 2003, October 1, 2004, October 1, 2006, and October 1, 2008.) are also available. In general, the data presented here represents a state’s policies applicable to adult Medicaid beneficiaries receiving care on a “fee for service” basis.
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