Expand chart
Data: Centers for Medicare & Medicaid Services via Health Management Associates; Chart: Axios Visuals

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.

Go deeper

Updated 19 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 9 a.m. ET: 31,092,895 — Total deaths: 961,301— Total recoveries: 21,274,210Map.
  2. U.S.: Total confirmed cases as of 9 a.m. ET: 6,812,470 — Total deaths: 199,517 — Total recoveries: 2,590,671 — Total tests: 95,108,559Map.
  3. Health: CDC updates guidances to say coronavirus can be spread through the air Nursing homes are evicting unwanted patients.
  4. Politics: Testing czar on Trump's CDC contradictions: "Everybody is right."
  5. Education: College students give failing grade on return to campus.
  6. Business: Unemployment concerns are growing.
  7. World: "The Wake-Up Call" warns the West about the consequences of mishandling a pandemic.
Ben Geman, author of Generate
50 mins ago - Energy & Environment

The climate stakes of the Supreme Court fight

Illustration: Aïda Amer/Axios

Ruth Bader Ginsburg's death and the battle over her vacant Supreme Court seat have real implications for energy and climate policy.

Why it matters: If President Trump replaces her, the court will likely become more skeptical of regulations that claim expansive federal power to regulate carbon under existing law, and perhaps new climate statutes as well.

Dion Rabouin, author of Markets
1 hour ago - Economy & Business

The tech war between the U.S. and China escalates

Illustration: Aïda Amer/Axios

Economic tension between the U.S. and China continues to escalate but is shifting in focus — away from the tit-for-tat trade war and toward a more direct confrontation over the future of technology at the heart of the conflict between the world's two largest economies.

Why it matters: The battle between the U.S. and China was always about tech supremacy and the direct confrontation could result in an accelerated splintering of global supply chains and a significant reduction of international commerce.