By NextBestFitState Medicaid share → UHP maintenance-of-effort payment
States pay UHP what they paid for Medicaid and Medicare buy-ins in 2024, indexed to per-capita NHE growth.
Result
$345.7B
$345.7B → $345.7B
Per resident, per year
$1,013
÷ 341.1M people
Per household
$2,615
÷ 132.2M households
How it's calculated
| # | Step | Arithmetic | Value |
|---|---|---|---|
| 1 | State share of Medicaid, 2024 Sources: CMS Office of the Actuary (2025) | $335.0B | |
| 2 | State Medicare buy-in premiums, 2024 Sources: CMS Office of the Actuary (2025) | $10.7B | |
| 3 | × MOE share 100% | ($335.0B + $10.7B) × 100% | $345.7B |
Inputs used
| Input | Kind | Value |
|---|---|---|
| State MOE as share of 2024 Medicaid + buy-in spending | policy, high confidence | 100% |
Trade-off: Existing public money keeps flowing, now to UHP instead of separate programs.
Sources: CMS Office of the Actuary (2025)