Illinois Medicaid Program Overview
Enrollment, funding, and managed care facts for Illinois Medicaid.
Get Illinois's Medicaid Fee Schedule →Enrollment
Illinois Medicaid covered approximately 2.94-3.42M people. Two independent sources give different-period figures for total Illinois Medicaid/CHIP enrollment: KFF's state indicator (2,939,165, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (3,418,634 total Medicaid enrollees, July 1, 2024). A third source, healthinsurance.org, reports ~3.2 million as of August 2025, falling between the two and tracing the same declining trend. Consistent with continued post-pandemic 'unwinding' enrollment decline, not a data error. Reported as a range rather than a single false-precision number.
Funding & federal match
Illinois has adopted ACA Medicaid expansion, effective 2014-01-01.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Illinois's Federal Medical Assistance Percentage (FMAP) is 51.82%.
Delivery system & managed care
A large share of Illinois Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 75.1-75.6% of Medicaid enrollees.
Waivers
Illinois operates Medicaid managed care under the Illinois Continuity of Care and Administrative Simplification Waiver, a Section 1115 demonstration waiver. Gives Illinois flexibility in Medicaid program design/administration to support continuity of care during eligibility transitions and administrative simplification. Approved June 19, 2021, current expiration December 31, 2025; the state is seeking a further extension through December 31, 2030.
Illinois operates Medicaid managed care under the Illinois Healthcare Transformation Waiver, a Section 1115 demonstration waiver. Provides additional program flexibility to support Illinois's Medicaid delivery-system transformation efforts. Five-year extension approved July 2, 2024, effective through June 30, 2029.
Has Illinois expanded Medicaid under the ACA?
Yes. Illinois has adopted ACA Medicaid expansion. Effective 2014-01-01.
How many people are enrolled in Illinois Medicaid?
Approximately 2.94-3.42M people.
What percentage of the federal Medicaid match does Illinois receive?
51.82% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 52 cents of every Illinois Medicaid dollar, and the state pays the rest.
Is most of Illinois Medicaid delivered through managed care?
Estimates range from 75.1-75.6% of Medicaid enrollees in managed care.
What Medicaid waivers does Illinois operate under?
Illinois Continuity of Care and Administrative Simplification Waiver, a Section 1115 demonstration waiver. Gives Illinois flexibility in Medicaid program design/administration to support continuity of care during eligibility transitions and administrative simplification. Approved June 19, 2021, current expiration December 31, 2025; the state is seeking a further extension through December 31, 2030.
What Medicaid waivers does Illinois operate under?
Illinois Healthcare Transformation Waiver, a Section 1115 demonstration waiver. Provides additional program flexibility to support Illinois's Medicaid delivery-system transformation efforts. Five-year extension approved July 2, 2024, effective through June 30, 2029.
Get Illinois's Free Medicaid Fee Schedule
Request actual Illinois 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)
- Illinois Department of Healthcare and Family Services - HR 1's Impact on Illinois Medicaid
- KFF - Status of State Action on the Medicaid Expansion Decision
- healthinsurance.org - Medicaid eligibility and enrollment in Illinois
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 29 (Percentage of Medicaid Enrollees in Managed Care by State, July 1, 2022)
- Medicaid.gov - Illinois Continuity of Care and Administrative Simplification, Section 1115 Demonstration and Waiver List
- Illinois Department of Healthcare and Family Services - 1115 Demonstration Waiver Home
- Medicaid.gov - Illinois Healthcare Transformation, Section 1115 Demonstration and Waiver List
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.