This document contains information about health insurance coverage in the United States in 2013. It shows that the largest sources of health insurance were employer-provided plans (48%), Medicaid (16%), Medicare (15%), and private plans (6%). It also notes that 13% of the population was uninsured. The document then discusses Medicaid and Medicare spending as part of the federal budget and shows these programs together account for nearly one-fourth of federal spending.

1. Medicaid
16%
Medicare
15%
Employer
48%
Other Private
6%
Other Public
2% Uninsured
13%
Health Insurance Coverage, 2013
313.4 Million
SOURCE: Kaiser Family Foundation estimates based on the Census Bureau's March 2014 Current Population Survey (CPS: Annual
Social and Economic Supplements). http://kff.org/other/state-indicator/total-population/.
Medicaid and Medicare Together Provide Health Insurance
Coverage for More than 3 in 10 Americans

2. Other
Mandatory2
13%
Discretionary
Defense
17%
Discretionary
Non-Defense
17%
Social Security
24%
Medicare1
14%
Medicaid
9%Net
Interest
6%
Actual FY 2014 Total Federal Outlays = $3.5 Trillion
NOTE: FY is fiscal year. 1 Amount for Medicare is mandatory spending minus income from premiums and other offsetting receipts such as state
contribution (clawback) payments to Medicare Part D). 2 ”Other” category includes other mandatory outlays (such as CHIP and Health Insurance
Marketplace premium subsidies) minus income from offsetting receipts.
SOURCE: Kaiser Family Foundation based on Congressional Budget Office, Budget and Economic Outlook Fiscal Years 2015-2025, January 2015.
Medicare and Medicaid Comprise Nearly One-Fourth of
Federal Spending

3. NOTE: FPL-- Federal Poverty Level. The FPL was $19,530 for a family of three in 2013.
SOURCES: Kaiser Commission on Medicaid and the Uninsured (KCMU) and Urban Institute analysis of 2013 CPS/ASEC Supplement;
Birth data - Maternal and Child Health Update, National Governors Association, 2012; Medicare data - Medicare Payment Advisory
Commission, Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid (January 2015), 2010 data; Functional Limitations -
KCMU Analysis of 2012 NHIS data; Nonelderly with HIV - 2009 CDC MMP; Nursing Home Residents - 2012 OSCAR data.
Medicaid’s Role for Selected Populations
1 in 5 Americans <65
1 in 3 children
2 in 3 nursing home residents

4. SOURCE: Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2010 Cost and Use file.
Characteristics of the Medicare Population
1 in 2 Medicare Beneficiaries
with incomes < $23,500
1 in 3 Medicare Beneficiaries
with 5+ chronic conditions
1 in 4 Medicare Beneficiaries
reporting fair/poor health status

5. 17% 17%
9%
30%
8%
22% 26%
22%
22%
28%
39%
43%
31%
52%
35%
Total Health
Services &
Supplies
$2,469 Billion
Hospital
Care
$937 Billion
Physicians
$587 Billion
Nursing Home
Care
$156 Billion
Prescription
Drugs
$271 Billion
Medicare
Medicaid
NOTE: Includes neither spending on CHIP nor administrative spending. Definition of nursing facility care was revised from previous
years and no longer includes residential care facilities for mental retardation, mental health or substance abuse. The nursing
facility category includes continuing care retirement communities.
SOURCE: CMS, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, 2015. Data for 2013.
Medicare and Medicaid Pay for Nearly 40% of Total Health
Care Spending Nationwide

6. 3.40%
4.10%
4.80%
Medicare Medicaid Private Insurance
Projected Average Annual Increase
in per capita spending, 2013-2023
SOURCE: Calculated based on data published in Projections (Table 17), National Health Expenditure Data. (Centers for Medicare &
Medicaid Services, December 2013,) http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-
Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html .
Medicare and Medicaid are Projected to Grow at Slower
Rates than Private Insurance

7. $2,264
$2,402
$2,098
$948
$6,012
$2,845
$1,956
$2,074
$8,276
$5,247
$4,054
$3,023
Ages 85+
Ages 75-84
Ages 65-74
Under age 65
Premiums
Services
NOTE: Analysis excludes beneficiaries enrolled in Medicare Advantage plans. Premiums includes Medicare Parts A and B and other
types of health insurance beneficiaries may have (Medigap, employer-sponsored insurance, and other public and private sources).
SOURCE: Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2010 Cost and Use file.
Affording the Rising Costs of Health Care
Medicare Beneficiaries’
Out of Pocket Costs
in 2010 for:

8. 18% 17% 15% 14% 13% 13% 13% 16% 19% 22% 23% 24% 25% 27% 28% 30% 31%
82% 83% 85% 86% 87% 87% 87% 84% 81% 78% 77% 76% 75% 73% 72% 70% 69%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Includes MSAs, cost plans, demonstration plans, and Special Needs Plans as well as other Medicare Advantage plans.
SOURCE: Authors’ analysis of CMS Medicare Advantage enrollment files, 2008-2015, and MPR, “Tracking Medicare Health and
Prescription Drug Plans Monthly Report,” 1999-2007; enrollment numbers from March of the respective year, with the exception
of 2006, which is from April.
The Increasing Role of Private Plans in Medicare
Medicare
Advantage
Traditional
Medicare
Share of Medicare Beneficiaries Enrolled in Medicare Private Health Plans, 1999-2015

9. 39.7
47.7
64.4
81.8
89.2
92.8
0
10
20
30
40
50
60
70
80
90
100
2000 2010 2020 2030 2040 2050
Number of Medicare beneficiaries (in millions)
SOURCE: Kaiser Family Foundation based on the 2014 Annual Report of the Boards of Trustees of the Federal Hospital Insurance
and Federal Supplementary Medical Insurance Trust Funds.
Financing Care for an Aging Population

10. TX
26%
FL
18%
NC
10%
GA
8%
Other States Not
Moving Forward
39%
Notes: Excludes legal immigrants who have been in the country for five years or less and immigrants who are undocumented.
The poverty level for a family of three in 2015 is $20,090. Totals may not sum to 100% due to rounding.
Source: “Number of Poor Uninsured Nonelderly Adults in the ACA Coverage Gap,” KFF State Health Facts.
http://kff.org/health-reform/state-indicator/number-of-poor-uninsured-nonelderly-adults-in-the-aca-coverage-gap/#.
Addressing the Coverage Gap in States that Have Not Expanded
Medicaid
3.7 Million Uninsured Low-Income
Share of Low-Income Uninsured Adults in
the Coverage Gap By State:

11. SOURCE: Medicaid Managed Care Enrollment Reports, 2000-2011, CMS.
The Increasing Role of Managed Care in Medicaid
38% 38% 39% 40%
41%
43% 44%
46% 47%
49%
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Share of Medicaid Enrollment in
comprehensive MCOs:

12. $3,985
$2,399 $3,234
$10,505
$4,091
$1,805
$64
$13
$6,137
$9,158
$5,790
$2,463
$3,247
$16,643
$13,249
Total Children Adults Individuals with
Disabilities
Elderly
Per Enrollee Spending, FFY 2011 Acute Care
Long-Term Care
Source: Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on data from FY 2011 MSIS and CMS-64
reports. Because 2011 data were unavailable, 2010 data was used for Florida, Kansas, Maine, Maryland, Montana, New Mexico, New
Jersey, Oklahoma, Texas, and Utah. Data for these 10 states were adjusted to 2010 spending levels.
Meeting the Varied Needs of Populations Covered in
Medicaid