Missouri Medicaid Program Overview
Enrollment, funding, and managed care facts for Missouri Medicaid.
Get Missouri's Medicaid Fee Schedule →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.
Has Missouri expanded Medicaid under the ACA?
Yes. Missouri has adopted ACA Medicaid expansion. Effective 2021-10-01.
How many people are enrolled in Missouri Medicaid?
Approximately 1.22-1.24M people.
What percentage of the federal Medicaid match does Missouri receive?
64.44% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 64 cents of every Missouri Medicaid dollar, and the state pays the rest.
Is most of Missouri Medicaid delivered through managed care?
Estimates range from 79.5-83.6% of Medicaid enrollees in managed care.
What Medicaid waivers does Missouri operate under?
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.
Get Missouri's Free Medicaid Fee Schedule
Request actual Missouri 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), Table 1
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 6 (FMAPs and E-FMAPs by State, FYs 2023-2026)
- KFF - Status of State Medicaid Expansion Decisions
- healthinsurance.org - Medicaid eligibility and enrollment in Missouri
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 29 (Percentage of Medicaid Enrollees in Managed Care by State, July 1, 2022)
- Medicaid.gov - MO Developmental Disabilities (DD) Comprehensive Waiver (0178.R07.00)
- Missouri Department of Mental Health - Home & Community Based Waivers
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.