Disclaimer: General educational research only — not legal, tax or financial advice. Rules differ by state and by family. Talk to an estate planning attorney in your state before you act.
Estate Planning Data & Research → Medicaid Dollars per Senior by State
Medicaid is the largest payer for long-term care, and after a recipient 55 or older dies, states must try to recover what Medicaid paid for that care from the estate. How much Medicaid spends in a state is one sign of how much is at stake.
This page compares Medicaid benefit spending in every state and D.C. in 2025 from the Bureau of Economic Analysis, scaled by each state’s population 65 and older and its total population.
Planning before long-term care is needed gives a family more choices about the home and savings. See how a trust and a will differ.
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Cite this page URL when reusing findings. Not a substitute for official sources or professional advice.
Key findings
- Medicaid benefits totaled $1.024 trillion in 2025, up 9.1% from $938 billion in 2024.
- That’s about $16,719 per resident 65+, or $3,011 per resident of any age. Medicaid covers all ages, so the per-65+ figure is a scale comparison, not spending on seniors alone.
- Highest per resident 65+: District of Columbia ($49,010), Alaska ($29,514), New York ($26,808), California ($26,020) and Kentucky ($25,758).
- Lowest: Wyoming ($6,725), Florida ($7,647), Alabama ($8,775), South Carolina ($9,765) and Georgia ($9,940).
- Per resident of any age, D.C. ($6,328) and New York ($5,070) lead; Wyoming ($1,343) is lowest.
Medicaid benefit spending by state, 2025
| State | Medicaid benefits 2025 | 2024 | Change (%) | Per resident 65+ | Per resident (all ages) |
|---|---|---|---|---|---|
| District of Columbia | $4.44B | $4.15B | 7.1 | $49,010 | $6,328 |
| Alaska | $3.23B | $2.85B | 13.2 | $29,514 | $4,363 |
| New York | $100.72B | $95.52B | 5.4 | $26,808 | $5,070 |
| California | $169.78B | $167.67B | 1.3 | $26,020 | $4,306 |
| Kentucky | $21.27B | $19.33B | 10.1 | $25,758 | $4,636 |
| New Mexico | $10.65B | $8.01B | 32.9 | $24,803 | $4,998 |
| Louisiana | $18.51B | $16.56B | 11.8 | $22,575 | $4,026 |
| Oregon | $18.90B | $17.15B | 10.2 | $22,232 | $4,424 |
| Minnesota | $21.18B | $20.18B | 4.9 | $20,048 | $3,655 |
| Massachusetts | $26.44B | $25.31B | 4.5 | $19,793 | $3,705 |
| Rhode Island | $4.35B | $3.77B | 15.4 | $19,741 | $3,908 |
| Pennsylvania | $50.34B | $41.29B | 21.9 | $18,881 | $3,849 |
| North Carolina | $35.63B | $28.76B | 23.9 | $17,988 | $3,225 |
| Washington | $24.23B | $20.03B | 21.0 | $17,579 | $3,045 |
| Maryland | $19.20B | $18.54B | 3.6 | $17,458 | $3,065 |
| Colorado | $16.27B | $14.14B | 15.1 | $16,601 | $2,732 |
| West Virginia | $6.32B | $4.98B | 27.0 | $16,345 | $3,572 |
| Ohio | $37.11B | $34.58B | 7.3 | $16,337 | $3,123 |
| Illinois | $36.97B | $34.16B | 8.2 | $16,253 | $2,909 |
| Oklahoma | $11.16B | $9.62B | 16.0 | $16,131 | $2,726 |
| Indiana | $19.34B | $19.21B | 0.6 | $15,869 | $2,792 |
| Connecticut | $11.32B | $11.14B | 1.6 | $15,862 | $3,079 |
| Maine | $5.07B | $4.77B | 6.2 | $15,358 | $3,606 |
| Virginia | $23.76B | $21.58B | 10.1 | $15,322 | $2,696 |
| Vermont | $2.27B | $2.17B | 4.8 | $15,298 | $3,503 |
| Arkansas | $8.59B | $8.01B | 7.2 | $15,267 | $2,782 |
| Arizona | $22.36B | $19.76B | 13.2 | $14,998 | $2,949 |
| Missouri | $17.27B | $15.94B | 8.3 | $14,768 | $2,765 |
| New Jersey | $25.10B | $23.70B | 5.9 | $14,709 | $2,642 |
| Delaware | $3.31B | $3.17B | 4.4 | $14,537 | $3,148 |
| Nebraska | $5.05B | $3.73B | 35.2 | $14,498 | $2,516 |
| Mississippi | $7.70B | $6.96B | 10.6 | $14,489 | $2,616 |
| Tennessee | $18.08B | $13.89B | 30.1 | $14,192 | $2,502 |
| Michigan | $27.94B | $26.01B | 7.4 | $14,054 | $2,755 |
| Iowa | $8.14B | $9.26B | -12.0 | $13,291 | $2,512 |
| Texas | $57.11B | $45.96B | 24.3 | $13,082 | $1,825 |
| Nevada | $7.19B | $6.30B | 14.2 | $12,493 | $2,200 |
| Kansas | $6.63B | $5.30B | 25.1 | $12,428 | $2,233 |
| North Dakota | $1.69B | $1.49B | 13.1 | $12,014 | $2,116 |
| Utah | $5.12B | $5.11B | 0.3 | $11,779 | $1,462 |
| Wisconsin | $13.31B | $12.47B | 6.7 | $11,365 | $2,233 |
| Idaho | $4.03B | $4.08B | -1.0 | $11,344 | $2,015 |
| Montana | $2.59B | $2.39B | 8.4 | $10,741 | $2,280 |
| South Dakota | $1.83B | $1.61B | 13.7 | $10,431 | $1,984 |
| New Hampshire | $3.08B | $2.73B | 12.7 | $10,147 | $2,184 |
| Hawaii | $3.13B | $3.00B | 4.3 | $10,048 | $2,163 |
| Georgia | $17.55B | $16.43B | 6.8 | $9,940 | $1,570 |
| South Carolina | $10.57B | $10.14B | 4.3 | $9,765 | $1,930 |
| Alabama | $8.38B | $8.30B | 0.9 | $8,775 | $1,625 |
| Florida | $38.96B | $36.39B | 7.1 | $7,647 | $1,667 |
| Wyoming | $0.79B | $0.79B | 0.3 | $6,725 | $1,343 |
| United States | $1023.95B | $938.39B | 9.1 | $16,719 | $3,011 |
Source: U.S. Bureau of Economic Analysis, Regional Economic Accounts, table SAINC35 (personal current transfer receipts), line 2221 Medicaid benefits, 2024 and 2025. Population: Census ACS 2024 1-year, table B01001. Sorted by dollars per resident 65+.
Why Medicaid spending matters for an estate
- Estate recovery. Federal law requires states to seek repayment for long-term care costs from the estates of recipients 55 and older. See Medicaid estate recovery by state.
- The home. Medicaid limits how much home equity an applicant can have. See Medicaid home equity limits by state.
- Nursing homes. See Medicaid nursing home days by state.
- Plan early. Medicaid looks back five years at transfers, so planning after a care crisis has fewer options.
Related research: Medicare dollars per older resident by state compares 2025 Medicare benefit spending in every state (BEA).
Methodology
BEA Regional Economic Accounts, SAINC35 line 2221 (Medicaid benefits paid to state residents, in thousands of dollars), pulled from the BEA API on Oct. 16, 2026 (2025 values are BEA’s latest estimates and will be revised). Per-resident figures divide by Census ACS 2024 1-year population (65+ and total); 2025 population estimates by single age were not used to keep one consistent source. Medicaid pays for children, adults under 65, people with disabilities and seniors; BEA does not split benefits by age, so dollars per resident 65+ is a scale comparison only.
What this doesn’t measure. Spending on seniors specifically, state administrative costs, quality or generosity of coverage, or expansion status. Year-to-year changes can reflect enrollment, payment timing and BEA methods.
Frequently asked questions
How much does Medicaid spend in total?
BEA estimates $1.02 trillion in Medicaid benefits in 2025.
Is this how much Medicaid spends on each senior?
No. It’s total Medicaid benefits divided by the number of residents 65+, so states can be compared on one scale. Medicaid covers all ages.
Can Medicaid take my parent’s house?
States must seek recovery from the estates of some recipients, and the home is often the main asset. Rules and exemptions vary; see the estate recovery page and talk to an elder law attorney.
Is this legal advice?
No. Talk to an estate planning attorney in your state.
Sources
Public-domain government sources only. Fetched 2026-10-16.
Data
- U.S. Bureau of Economic Analysis, Regional Data, SAINC35 Personal current transfer receipts (Medicaid, line 2221): https://apps.bea.gov/itable/?ReqID=70&step=1
- BEA API: https://apps.bea.gov/api/
- U.S. Census Bureau, American Community Survey 2024 1-year, table B01001 (API): https://api.census.gov/data/2024/acs/acs1
- Federal estate recovery requirement, 42 U.S.C. 1396p(b): https://www.ssa.gov/OP_Home/ssact/title19/1917.htm
Cite this data
Family Estate Guide, “Medicaid Dollars per Senior by State,” October 2026. https://familyestateguide.com/estate-planning-data/medicaid-dollars-per-senior-by-state/
You’re welcome to reuse the table with a link back to this page. The underlying government data is public.
Published October 16, 2026 by Family Estate Guide. Data vintage: BEA SAINC35 2025; Census ACS 2024 1-year. Editorial standards.