District of Columbia Medicaid Program Overview

Enrollment, funding, and managed care facts for District of Columbia Medicaid.

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0.24-0.28M
Enrolled
Expanded
ACA expansion status
70%
Federal match (FMAP), FFY2026
86.3-86.6%
In managed care

Enrollment

District of Columbia Medicaid covered approximately 0.24-0.28M people. Two independent sources give close but different-period figures for total DC Medicaid/CHIP enrollment: KFF's state indicator (238,011, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (275,158 total Medicaid enrollees, July 1, 2024). Consistent with a 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

District of Columbia has adopted ACA Medicaid expansion, effective 2014-01-01.

For FFY2026 (Oct 1, 2025 - Sep 30, 2026). Unlike the 50 states, DC's FMAP is not calculated from the per-capita-income formula -- it has been fixed in statute at 70% since FY1998 by Section 4725(b) of the Balanced Budget Act of 1997, which amended Social Security Act Section 1905(b). (For other, non-Medicaid/CHIP federal programs, DC's FMAP defaults to 50% unless otherwise specified by law.) Without this statutory exception DC would receive the 50% statutory floor like other high-income jurisdictions., District of Columbia's Federal Medical Assistance Percentage (FMAP) is 70%.

Delivery system & managed care

A large share of District of Columbia Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 86.3-86.6% of Medicaid enrollees.

Frequently Asked Questions

Yes. District of Columbia has adopted ACA Medicaid expansion. Effective 2014-01-01.

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