Medicaid Update for FY2024

On January 14, 2026, the Centers for Medicare and Medicaid Services (CMS) published its annual report on National Health Expenditures and its NHE Tables includes data on Medicaid from 1960 to 2023. On January 15, 2026, usgovernmentspending.com updated its Medicaid data.

Item	2024 Estimate	2024 Actual
Federal Medicaid	$567.2 bn	$567.2 bn
State Medicaid (net)	$124.4 bn	$253.2 bn
Total Medicaid	$691.6 bn	$820.4 bn

The federal Medicaid number comes from the Federal Budget Subfunction 558: Grants to states for Medicaid. The state contribution comes from the NHE Tables.

usgovernmentspending.com publishes "guesstimates" of state and local spending from the latest year published by the Census Bureau (currently FY 2023) to the last year in the Historical Tables of the federal budget. (currently 2029 from the FY25 budget). So we have developed "guesstimates" of Medicaid spending going out to 2029, assuming that the overall Medicaid spending increases at the same rate as the federal "Grants to States for Medicaid" increases.

National Health Expenditure data is updated each year in mid December. 

CBO Long Term Budget Outlook for 2025

On March 27, 2025 the Congressional Budget Office released its annual Long Term Budget Outlook for 2025, which projects federal spending and revenue out to 2055.  As before, the data for the CBO study shows that federal health-care programs and interest costs will eat the budget, with federal spending exceeding 25 percent GDP by the 2040s while federal revenue stays a little over 19 percent GDP.

UsGovernmentspending.com has updated its chart of the CBO Long Term Budget Outlook here.  You can download the data and also view CBO Long Term Budget Outlooks going back to 1999.

State FY25 Taxes Update

On November 22, 2025 usgovernmentspending.com updated FY2025 state revenue with quarterly tax data released by the US Census Bureau on September 2, 2025.  Local tax data was updated by assuming that local taxes for 2024 changed by the same percent as state taxes of the same type.

$ billion	FY2025 Estimate	FY2025 Actual
State Income Tax Revenue	$908	$798
Total State Revenue	$2,815	$3.072

State and local spending projections for FY2026 to FY2029 have been reestimated using the "Guesstimate" method.