Missouri Medicaid Program Overview

Enrollment, funding, and managed care facts for Missouri Medicaid.

Get Missouri's Medicaid Fee Schedule →
1.22-1.24M
Enrolled
Expanded
ACA expansion status
64.44%
Federal match (FMAP), FFY2026
79.5-83.6%
In managed care

Enrollment

Missouri Medicaid covered approximately 1.22-1.24M people. Two independent sources give close but different-period figures for total Missouri Medicaid/CHIP enrollment: KFF's state indicator (1,243,830, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (1,222,962 total Medicaid enrollees, July 1, 2024). Different reporting periods, not a contradiction; reported as a range rather than a single false-precision number.

Funding & federal match

Missouri has adopted ACA Medicaid expansion, effective 2021-10-01.

For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Missouri's Federal Medical Assistance Percentage (FMAP) is 64.44%.

Delivery system & managed care

A large share of Missouri Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 79.5-83.6% of Medicaid enrollees.

Waivers

Missouri operates Medicaid managed care under the Missouri Developmental Disabilities (DD) Comprehensive Waiver, a Section 1915(c) demonstration waiver. Home and community-based services waiver for individuals with developmental disabilities, administered by the Missouri Department of Mental Health's Division of Developmental Disabilities. Provides long-term services and supports in community settings as an alternative to institutional care. Originally approved 1988; current approval period July 1, 2021 through June 30, 2026.

Frequently Asked Questions

Yes. Missouri has adopted ACA Medicaid expansion. Effective 2021-10-01.

Get Missouri's Free Medicaid Fee Schedule

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