States ranked by annual Medicaid managed care spend

By Jakob Emerson / November 7, 2023

New York spends the most on its Medicaid managed care program every year, according to data published by KFF in November. The U.S. total is more than $441 billion.

KFF sourced Urban Institute estimates based on data from CMS, as of September 2023. In Nebraska, some long-term Medicaid spending is reported under managed care. New York data may reflect anomalous spending due to adjustments, changes in expenditures and lags in state claims.

Total managed care spending includes payments made to health maintenance organizations, prepaid health plans and other health plans, along with primary care case management fees.

States ranked by annual Medicaid managed care spend:

  1. New York: $50.8 billion

  2. California: $50.5 billion

  3. Texas: $37.5 billion

  4. Pennsylvania: $32.3 billion

  5. Florida: $22.1 billion

  6. Ohio: $19.8 billion

  7. Illinois: $19 billion

  8. Arizona: $16.3 billion

  9. Michigan: $13.9 billion

  10. New Jersey: $13.7 billion

  11. Washington: $12.3 billion

  12. Virginia: $10.9 billion

  13. Kentucky: $10.3 billion

  14. North Carolina: $10 billion

  15. Louisiana: $9.9 billion

  16. Massachusetts: $8.6 billion

  17. Indiana: $8.3 billion

  18. Minnesota: $8.1 billion

  19. Tennessee: $8 billion

  20. Oregon: $7.7 billion

  21. Maryland: $6.6 billion

  22. New Mexico: $6.6 billion

  23. Iowa: $6.1 billion

  24. Wisconsin: $6 billion

  25. Georgia: $5.5 billion

  26. Arkansas: $4.1 billion

  27. Kansas: $3.9 billion

  28. Missouri: $3.6 billion

  29. South Carolina: $3.4 billion

  30. Hawaii: $2.7 billion

  31. Mississippi: $2.6 billion

  32. Nevada: $2.5 billion

  33. Delaware: $2.5 billion

  34. West Virginia: $2.4 billion

  35. Colorado: $2.2 billion

  36. Utah: $2.1 billion

  37. Nebraska: $2 billion

  38. Rhode Island: $1.9 billion

  39. District of Columbia: $1.6 billion

  40. New Hampshire: $1.1 billion

  41. Idaho: $828.6 million

  42. North Dakota: $423.1 million

  43. Connecticut: $135.6 million

  44. Alabama: $132.3 million

  45. Oklahoma: $81.9 million

  46. Montana: $52.8 million

  47. Maine: $10.8 million

  48. Wyoming: $2.4 million

  49. South Dakota: $1.4 million

  50. Alaska: $692,683

  51. Vermont: $0

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States ranked by annual Medicaid DSH payments

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