SALT LAKE CITY — States and the federal government share a vital economic relationship. This data summary, the seventh in a series on state and federal economic linkages from the Kem C. Gardner Policy Institute, presents the Utah-federal government nexus for Medicaid.
“Since Utah adopted Medicaid in 1966, changes in federal requirements and within the Utah Medicaid program have expanded coverage to new population groups, such as low-income adults, and additional services like behavioral health,” said Maddy Oritt, senior public finance economist at the Gardner Institute. “Medicaid services are eligible for federal Medicaid match. This means that for every dollar spent on most services, the federal government pays 64 cents, and Utah pays 34 cents.”
Key findings from the summary include the following:
Size and Composition – Medicaid and CHIP (the Children’s Health Insurance Program) fund health care services for about 353,000 Utahns with low income as of February 2025. This represents about 10% of Utah’s population. Medicaid primarily serves low-income children, pregnant women, adults with a qualifying status (e.g., parents/caretakers), and individuals with disabilities. In 2018, Utah voters also expanded Medicaid eligibility to low-income adults with annual incomes up to 138% of the federal poverty level (FPL).
Federal Funding– The federal government funded $3.6 billion (68%) of Utah’s $5.3 billion overall Medicaid costs in FY 2024. The state of Utah, along with local governments and certain health care entities, funded the remaining $1.7 billion (32%). Most Medicaid services are eligible for the traditional federal Medicaid match, which funds about 64% of the FY 2025 traditional Medicaid costs.
Location – Most Medicaid enrollees reside along the Wasatch Front. When viewed as a share of each county’s total population, Medicaid enrollment is highest in San Juan County (30.0%), Carbon County (22.5%), and Duchesne County (20.9%). Medicaid enrollment as a share of the population is lowest in Summit County (4.3%) and Morgan County (4.5%).