States and the federal government paid health insurance companies $307 billion in 2018 to run Medicaid programs, according to the latest numbers obtained by consultancy Health Management Associates. That was 52% of all Medicaid spending — up significantly from 2007, when private insurers handled 20% of Medicaid spending.
The big picture: This shift has occurred, and will continue, because more states are privatizing their Medicaid programs and because the Affordable Care Act expanded Medicaid eligibility to more low-income people. However, costs and quality concerns linger over Medicaid managed care.