Alabama Medicaid Program Overview
Enrollment, funding, and managed care facts for Alabama Medicaid.
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Alabama Medicaid covered approximately 0.93-1.10M people. Two independent sources give different-period figures for total Alabama Medicaid/CHIP enrollment: KFF's state indicator (933,487, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (1,098,614 total Medicaid enrollees, July 1, 2024). The gap is larger than a same-period rounding difference would explain; consistent with continued post-pandemic 'unwinding' enrollment decline between mid-2024 and mid-2026, not a data error. Reported as a range rather than a single false-precision number.
Funding & federal match
Alabama has not adopted ACA Medicaid expansion.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Alabama's Federal Medical Assistance Percentage (FMAP) is 72.63%.
Delivery system & managed care
A large share of Alabama Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 0% of Medicaid enrollees.
Waivers
Alabama operates Medicaid managed care under the Alabama Community Waiver Program, a Section 1115 demonstration waiver. Provides home and community-based services (HCBS) to individuals with intellectual disabilities as an alternative to institutional care; approved for a five-year period, October 21, 2021 through September 30, 2026, initially covering roughly 500 individuals (about 25% of the state's ID waiver waiting list at approval).
Alabama operates Medicaid managed care under the Alabama Plan First Family Planning Demonstration, a Section 1115 demonstration waiver. Provides family planning and family-planning-related services to eligible low-income individuals who would not otherwise qualify for full Medicaid; originally approved in 2000, most recently extended in 2021/2023.
Frequently Asked Questions
Get Alabama's Free Medicaid Fee Schedule
Request actual Alabama Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- Federal Register / GPO - Federal Financial Participation in State Assistance Expenditures, FFY2026 FMAP Notice (2024-27910)
- KFF State Health Facts - Federal Matching Rate (FMAP) for Medicaid
- KFF - Status of State Action on the Medicaid Expansion Decision
- healthinsurance.org - Medicaid eligibility and enrollment in Alabama
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 29 (Percentage of Medicaid Enrollees in Managed Care by State, July 1, 2022)
- Medicaid.gov - Alabama Community Waiver Program, Special Terms and Conditions
- Alabama Medicaid Agency - Home and Community Based Services Waivers
- Alabama Medicaid Agency - Family Planning 1115 Waiver
- Medicaid.gov - Alabama Medicaid Agency Plan First Program Section 1115 Demonstration Annual Report
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.