Minnesota leads the nation in Medicaid spending. That trend continued in 2024, according to preliminary data from the Kaiser Family Foundation (KFF).
Specifically, after including federal money, Minnesota spent $12,695 per full-benefit Medicaid enrollee in 2024. No other state spent more than Minnesota. The next two highest-spending states were North Dakota and Vermont, both of which lagged behind Minnesota by more than $600 per enrollee. Not to mention, median state (Idaho) spent $8,905 per average enrollee — 30 percent less than Minnesota.
While Minnesota is an all-around leader, the state is an even more extreme outlier when looking at certain eligibility categories — most notably, individuals with disabilities. Minnesota spent $64,150 per enrollee in this category in 2024, more than $6,000 higher than was spent in 2023.
As in 2023, Minnesota ranked first in the country in 2024, outspending the number two state (Maryland) by more than $15,000. Minnesota also spent more than double the median state (Rhode Island).
Because of categorization differences, KFF rankings differ slightly from those provided by the Centers for Medicare and Medicaid Services (CMS). However, Minnesota remains a spending leader regardless of data source, proving its persistent and growing generosity.
CMS data, for instance, shows that in 2023, Minnesota ranked third-highest in spending per average full-benefit enrollee, surpassed only by Pennsylvania and Washington. For people with disabilities, Minnesota was the number one state (as with KFF data), outspending Washington (the #2 state) by over $9,000 per person.
What this means for the 2027 legislative session
While the federal government covers over half of all Medicaid spending, recent growth in the program, particularly for individuals with disabilities, has significantly expanded the state budget, causing the state to spend more than it is bringing in.
Per data from the Minnesota Management and Budget (MMB), after adjusting for inflation, general fund Medicaid spending in 2026 was 36 percent higher than it was in 2023. By 2029, spending will be 45 percent higher. And while Medicaid accounted for 20 percent of the state budget in 2023, its share will reach 28 percent in 2029, making it the primary driver of budget growth.
This means that as legislators meet in the 2027 session to craft the next state budget, addressing Medicaid’s trajectory will be key to getting Minnesota back on the right track.
To balance the budget and deliver tax relief, as promised by Governor-elect Amy Klobuchar, legislators will need to rethink the state’s leadership in Medicaid spending — and examine the policies that have led the state to this point. Revisiting the 2023 session is a good start.