Overview
- KFF published updated linked Medicare‑Medicaid analyses on July 15, 2026, that identify roughly 12 million Americans enrolled in both programs and quantify their use of services and spending.
- Dual-eligible people make up about 15% of traditional Medicare beneficiaries but account for 29% of traditional Medicare spending and represent 13% of Medicaid enrollment while driving about 30% of combined Medicaid spending.
- The group faces much greater health and functional needs than other Medicare beneficiaries, with 44% reporting fair or poor health, 47% reporting a mental health condition, and 47% having difficulty with at least one activity of daily living.
- Medicaid provides critical wraparound support for many duals—nearly 5 million used at least one service such as long-term care, vision, dental, or nonemergency transport in 2021—and Medicaid pays about 61% of national long-term care spending.
- KFF models that HR 1, signed July 4, 2025, would cut federal Medicaid funding by about $911 billion over 10 years and could lead to roughly 1.3 million dual-eligible people losing Medicaid by 2034, which could shift care costs to states, reduce access to long-term services, and increase strain on family caregivers.