As U.S. unemployment rose to 14.7% in April, millions of Americans are seeking unemployment benefits through Medicaid. Medicaid is notoriously underfunded at both the federal and state levels; however, some states are capable of providing better Medicaid benefits than others.

Key findings:

  • The 14.7% unemployment rate has left many Americans seeking Medicaid benefits.
  • Nationally, 21% of people receive Medicaid benefits.
  • New York, New Hampshire and Wisconsin were found to provide the best Medicaid programs in the country.
  • States with the best Medicaid programs spend 65% more per person than bottom-level states.
  • Top-end states fund their Medicaid programs with higher rates of state-provided funding.
  • 29% of people in Medicaid expansion states became eligible with expansion under the Affordable Care Act.

Our team analyzed Kaiser Family Foundation data on Medicaid costs and funding to see which states offer the best Medicaid benefits. We evaluated three factors to determine each state’s capacity to deliver the best Medicaid benefits.

  • Cost of physician fee for service — Costs the state pays providers directly for each covered service received by a Medicaid beneficiary. Figures reflect a state’s fees relative to the national average. A rating of 1.00 is considered to be an average cost.
  • Medicaid funding per beneficiary — Total funding for the state Medicaid program per person on Medicaid in the state.
  • Percentage of total Medicaid funding by the state — The funding each state provides compared to federal funds. On average, nationwide, there is a 65% federal funding and 35% state funding for Medicaid in each state.

Each ranking factor was analyzed to compile a composite score determining each state’s overall capacity to provide the best Medicaid benefits.

Rank State Unemployment Rate Cost of Physician Fee for Service Total Spending Per Person % State Spending
1 New York 14.5% 0.85 $12,591 49%
2 New Hampshire 16.3% 0.81 $11,596 40%
3 Wisconsin 14.1% 0.8 $10,090 41%
4 Minnesota 8.1% 1.04 $11,633 43%
5 New Jersey 15.3% 0.64 $8,856 40%
6 Pennsylvania 15.1% 0.93 $10,321 41%
7 Missouri 9.7% 0.79 $10,760 35%
8 Rhode Island 17.0% 0.53 $8,393 41%
9 Texas 12.8% 0.88 $8,842 43%
10 Maine 10.6% 0.85 $10,742 36%
11 Kansas 11.2% 1.01 $9,269 45%
12 Illinois 16.4% 0.85 $7,580 42%
13 Virginia 10.6% 1.1 $8,652 50%
14 California 15.5% 0.76 $6,822 40%
15 Massachusetts 15.1% 1.12 $8,670 45%
16 Vermont 15.6% 1.11 $8,907 41%
17 Wyoming 9.2% 1.38 $9,958 47%
18 Nebraska 8.3% 1.14 $8,535 47%
19 North Dakota 8.5% 1.35 $13,340 39%
20 Connecticut 7.9% 1.16 $9,116 41%
21 South Dakota 10.2% 1.1 $8,450 40%
22 Ohio 16.8% 0.85 $7,269 31%
23 Indiana 16.9% 1.05 $9,369 29%
24 Florida 12.9% 0.79 $5,797 38%
25 Hawaii 22.3% 0.89 $6,878 34%
26 Iowa 10.2% 1.04 $8,284 34%
27 Colorado 11.3% 1.13 $6,997 42%
28 Delaware 14.3% 1.4 $10,953 35%
29 Maryland 9.9% 1.35 $9,298 39%
30 Washington 15.4% 0.98 $6,662 38%
31 Oregon 14.2% 1.11 $9,369 27%
32 Oklahoma 13.7% 1.14 $7,282 39%
33 Michigan 22.7% 0.9 $6,698 29%
34 Kentucky 15.4% 0.98 $7,509 22%
35 Alaska 12.9% 2.28 $10,457 28%
36 Louisiana 14.5% 0.97 $6,452 28%
37 Utah 9.7% 1.19 $8,249 30%
38 North Carolina 12.2% 1.05 $6,090 32%
39 Arkansas 10.2% 0.98 $6,837 22%
40 Georgia 11.9% 1.02 $5,408 31%
41 Alabama 12.9% 0.95 $5,460 28%
42 West Virginia 15.2% 1.08 $6,862 21%
43 Mississippi 15.4% 1.17 $7,490 24%
44 South Carolina 12.1% 1.05 $4,946 28%
45 Idaho 11.5% 1.25 $6,179 29%
46 Arizona 12.6% 1.11 $6,074 23%
47 Tennessee 14.7% N/A $5,999 34%
48 Montana 11.3% 1.56 $7,060 22%
49 Nevada 28.2% 1.37 $6,574 25%
50 New Mexico 11.3% 1.19 $5,915 21%

Since early March, when COVID-19 began to increase unemployment claims, over 44 million Americans have filed for unemployment. Many of those 44 million jobless claims are seeking Medicaid benefits after loss of employer-sponsored health insurance. According to a study by One Fair Wage, 44% of U.S. unemployment claim applicants have been denied or are still waiting to receive unemployment benefits. The large number of Americans still waiting on unemployment benefits can be attributed to states’ capacity and ability to deliver benefits such as Medicaid. Our analysis of state-level Medicaid data can shed light on which states are capable of delivering eligibility and benefits better than others.

We evaluated each state’s ability to deliver Medicaid benefits on the cost of healthcare and how well funded states are for Medicaid. Both costs and funding appear to correlate closely as primary factors that would determine how well a beneficiary receives Medicaid benefits. The concerning figure is that states hit hardest by unemployment, like Nevada (28.2%) and Michigan (22.7%), are also among the worst states for Medicaid benefits. There’s going to be a high number of people seeking Medicaid benefits in those states that will receive the lowest benefit rates. Nevada and Michigan both have low percentages of state-funded spending along with low spending per person. This becomes problematic because states with the largest numbers of unemployed people also provide the least overall funding and high costs for those Medicaid beneficiaries.

On the other hand, you also have high unemployment states like Rhode Island, New Hampshire and California that are rated among the best states for Medicaid benefits. Good cost figures and funding among these states gives them the ability to better provide Medicaid benefits to their high numbers of unemployed residents. The unfortunate reality from evaluating Medicaid data in each state is that depending where you live in America, you could receive an unfair mix of health care benefits. A well-funded Medicaid program in one state will provide better for an unemployed person or family than another state.

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