The Current Size of Medicare and Medicaid

As of 2024, roughly 67 million people are enrolled in Medicare and about 72 million are enrolled in Medicaid. These numbers overlap — some people hold both programs at the same time, usually those over 65 with very low income. The exact count shifts month to month as people turn 65, lose or gain income, or move between states.

Medicare covers nearly all Americans aged 65 and older, plus some younger people with disabilities or end-stage renal disease. Medicaid covers low-income adults, children, pregnant people, and seniors in every state, but the income thresholds and covered services vary widely by state. Together, these two programs cover roughly one in five Americans.

These figures come from the Centers for Medicare & Medicaid Services (CMS), which publishes enrollment data quarterly. The numbers are public but not always straightforward to find — CMS updates them on its website, and state Medicaid agencies publish their own enrollment reports.

Key Takeaways

  • Medicare covers about 67 million people, mostly those 65 and older, while Medicaid covers about 72 million people with low income across all ages.
  • Some people hold both Medicare and Medicaid at the same time, usually seniors with very low income — these people are called "dual may be able to access."
  • Medicaid enrollment varies dramatically by state because each state sets its own income limits and decides which services to cover.
  • Medicare enrollment is relatively stable because it is tied to age, but Medicaid enrollment rises and falls with economic conditions and state policy changes.

Why Medicare and Medicaid Numbers Matter to You

Understanding how many people use these programs tells you something important: you are not alone if you rely on them, and the programs are large enough to have real infrastructure behind them. Medicare and Medicaid together account for roughly one-third of all U.S. healthcare spending, which means they shape how hospitals, doctors, and pharmacies operate.

The size of these programs also affects wait times, provider availability, and policy changes. When enrollment grows, states and the federal government sometimes struggle to process paperwork quickly or find enough doctors willing to accept the payment rates. When enrollment shrinks, programs may tighten rules or reduce covered services. Knowing the scale helps you understand why certain changes happen and what to expect.

How Medicare Enrollment Breaks Down by Age and Disability

Of the 67 million Medicare enrollees, about 60 million are aged 65 and older. The remaining 7 million are younger people with disabilities, including those who have received Social Security Disability Insurance (SSDI) for at least two years, and people of any age with end-stage renal disease or ALS.

Medicare enrollment grows by roughly 10,000 people per day as the Baby Boomer generation ages. This steady growth is why Medicare is sometimes described as facing a "funding challenge" — the program was designed when fewer people lived past 65, and now more people live longer and use more services. The growth is predictable because it is tied to age, not to economic conditions.

How Medicaid Enrollment Varies by State

Medicaid enrollment is far less uniform than Medicare because each state runs its own program within federal guidelines. A single parent in one state might earn too much to may have access to for Medicaid, while the same parent in another state would be covered. This variation means the 72 million national figure masks huge differences in who is actually covered where you live.

States also expanded Medicaid at different times under the Affordable Care Act. As of 2024, 38 states plus Washington D.C. have expanded Medicaid to cover adults earning up to 138 percent of the federal poverty line. The remaining 12 states have not expanded, so their Medicaid programs cover far fewer working-age adults. If you live in a non-expansion state and earn above your state's threshold, you may not may have access to even if you have very low income.

Medicaid enrollment also swings with the economy. During recessions, more people lose jobs and income, so enrollment rises. During strong economic periods, enrollment falls as people find work and earn more. The COVID-19 pandemic caused a temporary freeze on Medicaid disenrollment, which inflated the numbers temporarily — many states spent 2023 and 2024 processing people who no longer may have access to.

The Overlap: People on Both Medicare and Medicaid

Roughly 12 million people hold both Medicare and Medicaid. These "dual may be able to access" individuals are usually seniors aged 65 and older with income below their state's Medicaid threshold, or younger disabled people whose income is very low. Dual may be able to access people often have higher healthcare costs and more complex needs than people on either program alone.

Being dual may be able to access changes how your coverage works. Medicare is your primary payer for most services, and Medicaid fills in gaps — it covers Medicare premiums, deductibles, and copayments, and it covers some services Medicare does not, like long-term care. The coordination between the two programs is supposed to be seamless but often is not, which is why dual may be able to access people sometimes face confusion about which program pays for what.

How Enrollment Numbers Have Changed Over Time

Medicare enrollment has grown steadily since the program began in 1965. In 1970, Medicare covered 20 million people. By 2000, that number had doubled to 40 million. Today it stands at 67 million, reflecting both population growth and the aging of the Baby Boom generation.

Medicaid enrollment has been more volatile. The program started in 1965 covering about 4 million people. It grew to 30 million by 1990, then to 50 million by 2010. The Affordable Care Act expansion in 2014 pushed enrollment toward 75 million, but the COVID-era freeze and subsequent disenrollment brought it back down. These swings reflect policy changes and economic conditions far more than Medicare's steady age-driven growth.

Where to Find Current Enrollment Data

If you need the most recent Medicare enrollment figures, visit the CMS website and search for "Medicare enrollment statistics." CMS publishes a monthly enrollment report that breaks down enrollment by age, state, and type of coverage (Original Medicare versus Medicare Advantage).

For Medicaid, your state's Medicaid agency publishes its own enrollment data, usually on its website under "reports" or "statistics." The Kaiser Family Foundation also publishes a state-by-state Medicaid enrollment tracker that is updated regularly and easier to navigate than state websites. If you need historical data or want to compare states, the Kaiser tracker is your fastest route.

Frequently Asked Questions

Does being on Medicare or Medicaid mean I am part of these enrollment numbers?

Yes. If you are enrolled in either program, you are counted in these figures. The numbers represent actual people with active coverage, not people who are merely may be able to access or who have applied. If you have Medicare or Medicaid, you are part of the 67 or 72 million.

Why do the numbers change so much for Medicaid but not Medicare?

Medicare enrollment is tied to age — people turn 65 every day at a predictable rate, so the growth is steady and expected. Medicaid enrollment depends on income, state policy, and the economy, all of which shift unpredictably. When the economy weakens, more people may have access to. When states change their income limits, enrollment jumps or drops overnight.

If I am on both Medicare and Medicaid, am I counted twice in these numbers?

Yes, you are counted once in the Medicare total and once in the Medicaid total. The 67 million and 72 million are separate counts, so the overlap is counted in both. This is why the two numbers do not add up to the total number of people covered — some people are in both.

How do I know if my state expanded Medicaid?

Visit your state's Medicaid website or call your state Medicaid office and ask directly whether your state has expanded Medicaid to cover adults earning up to 138 percent of the federal poverty line. If it has, the answer will be yes. If not, your state covers only certain groups like children, pregnant people, and parents earning below a much lower threshold.

Are these enrollment numbers the same as the number of people who actually use these programs?

Not exactly. Enrollment numbers count people with active coverage, but not everyone with coverage uses services in a given year. Some people are enrolled but do not see a doctor or fill prescriptions. The enrollment count is higher than the number of people who actually receive care, but it is the most reliable measure of how many people have coverage available to them.