How much each state has spent to expand Medicaid 

By Jakob Emerson / November 22, 2024

States spend nearly $40 billion annually on expanded Medicaid coverage under the ACA, according to KFF.

Medicaid is financed by the federal government and the states based on per capita income. The federal funding share varies from 50% to 74%, depending on the state. The ACA expanded Medicaid eligibility in 2014, and the federal government has paid for 90% of expansion costs since 2020.

The ranking below lists state spending in 2023 for adults who have enrolled in Medicaid through the ACA's expansion of the program. It does not include spending on traditional Medicaid or federal spending for the expansion group. Ten states have not expanded Medicaid under the ACA.

How much each state has spent to expand Medicaid:

  1. California: $3,268,018,800

  2. New York: $2,689,050,600

  3. Illinois: $1,895,262,700

  4. Washington: $1,016,797,100

  5. Ohio: $789,815,500

  6. Pennsylvania: $787,076,100

  7. Michigan: $710,094,100

  8. Arizona: $709,590,200

  9. Louisiana: $708,047,200

  10. Virginia: $692,144,700

  11. New Jersey: $621,022,700

  12. Kentucky: $578,826,600

  13. Oregon: $506,854,800

  14. Connecticut: $484,935,900

  15. Indiana: $453,552,600

  16. Maryland: $399,059,600

  17. Massachusetts: $373,670,100

  18. Minnesota: $354,687,500

  19. Colorado: $332,704,000

  20. Missouri: $281,864,300

  21. Arkansas: $277,126,900

  22. Oklahoma: $233,386,800

  23. Nevada: $217,824,300

  24. New Mexico: $211,870,300

  25. Iowa: $158,525,300

  26. West Virginia: $145,475,300

  27. Utah: $113,261,900

  28. Hawaii: $103,935,500

  29. Montana: $94,964,700

  30. Nebraska: $93,805,700

  31. Delaware: $92,409,500

  32. Maine: $92,354,200

  33. Rhode Island: $88,602,700

  34. Idaho: $86,314,200

  35. District of Columbia: $77,432,200

  36. New Hampshire: $50,356,100

  37. North Dakota: $47,138,000

  38. Alaska: $38,918,200

  39. Vermont: $32,495,600

  40. South Dakota: $960,000

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