Alabama Medicaid Program Overview
Enrollment, funding, and managed care facts for Alabama Medicaid.
Get Alabama's Medicaid Fee Schedule →Enrollment
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.
Has Alabama expanded Medicaid under the ACA?
No. Alabama has not adopted full Medicaid expansion under the Affordable Care Act as of 2026.
How many people are enrolled in Alabama Medicaid?
Approximately 0.93-1.10M people.
What percentage of the federal Medicaid match does Alabama receive?
72.63% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 73 cents of every Alabama Medicaid dollar, and the state pays the rest.
Is most of Alabama Medicaid delivered through managed care?
Estimates range from 0% of Medicaid enrollees in managed care.
What Medicaid waivers does Alabama operate under?
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).
What Medicaid waivers does Alabama operate under?
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.
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.