Medicaid Plays an Important Role in Providing Health Coverage to Key Populations

Nearly 70 million people with low incomes got their health coverage through Medicaid as of October 2025.^[1] The program is a critical source of coverage for many populations, but the Republican megabill, enacted in July 2025, cuts more than $900 billion from Medicaid. According to the Congressional Budget Office, this will cause 7.5 million people to lose Medicaid coverage and become uninsured by 2034.^[2] Preserving Medicaid coverage is essential to protecting the health of people across a number of populations, including children, adults, and people with disabilities.

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Medicaid ensures that people of all ages have access to the health care they need, covering 2 in 5 children, 1 in 6 non-elderly adults, and 1 in 7 seniors nationwide.^[3] (See Figure 1.)

Around 12 million low-income seniors and people with disabilities were enrolled in both Medicare and Medicaid — so-called “dual eligibles” — as of November 2025, representing 1 in 6 Medicare enrollees.^[4] Medicaid provides dual eligible enrollees with assistance for Medicare premiums and other out-of-pocket costs, along with coverage for certain services not covered by Medicare, such as non-emergency medical transportation and long-term care.

Medicaid covers 3 in 5 children with disabilities and 2 in 5 non-elderly adults with disabilities.^[5] While people can qualify for Medicaid on the basis of a disability, eligiblity through disability pathways is limited to people who meet stringent disability criteria. As a result, income-based eligibility pathways (e.g., children, parents, Affordable Care Act expansion adults) are another important source of coverage for people with disabilities. For instance, 2 in 3 non-elderly Medicaid adults with disabilities do not receive Supplemental Security Income; it is likely that many of these people are enrolled through a non-disability pathway such as the Affordable Care Act’s Medicaid expansion.^[6]

Medicaid expansion has substantially improved access to health coverage. As of June 2025, around 20 million non-elderly adults with low incomes were enrolled through the Affordable Care Act’s Medicaid expansion,^[7] which gives states the option to extend eligibility for low-income adults. In the 40 states and the District of Columbia that have implemented the expansion, Medicaid covers almost 1 in 5 non-elderly adults, compared with 1 in 10 non-elderly adults in the ten remaining non-expansion states.^[8]

Nearly 2 in 3 adult Medicaid enrollees work — many in low-paying occupations that do not offer job-based coverage — and most enrollees who are not working have a disability, are caring for family members, or are attending school.^[9] (See Figure 2.) The Medicaid expansion provides a pathway to affordable coverage for many of these people. Nevertheless, the Republican megabill undermines the expansion by adding unprecedented red tape, including a harsh work requirement and more frequent eligibility redeterminations. As a result of these policies, 6 million people could lose health coverage and become uninsured by 2034.^[10]

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Medicaid provides coverage for people across racial and ethnic groups. For children and adults ages 0 to 64, it covers 1 in 6 white people, 1 in 3 Black people, 3 in 10 Latino people, 1 in 6 Asian people, 2 in 5 American Indian or Alaska Native people, 3 in 10 Native Hawaiian or Other Pacific Islander people, and 1 in 4 multiracial people. ^[11] In 2024, people of color made up 47 percent of the non-elderly U.S. population, but 62 percent of the non-elderly Medicaid population.^[12] (See Figure 3.) While this reflects the systemic inequities that make people of color more likely to have low incomes that qualify for Medicaid, it also shows the critical role Medicaid plays in reducing inequities in uninsured rates.

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Medicaid meets important needs for many populations. This includes covering:

• 2 in 5 of all U.S. births;^[13]
• 1 in 4 rural children and non-elderly adults, compared with 1 in 5 urban children and non-elderly adults;^[14]
• 1 in 5 women of reproductive age;^[15] and
• 1 in 10 veterans.^[16]

Medicaid is also the primary payer of certain key services that people across the country need. For example, Medicaid covers:

• 1 in 4 people with either a substance use disorder or a mental illness;^[17] and
• the majority — 3 in 5 — of nursing facility residents.^[18] (See Figure 4.)

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