A Profile of Dual-Eligible Individuals Authors: Abby Wolk, Nancy Ochieng, Jeannie Fuglesten Biniek, and Alice Burns Published: Jul 15, 2026 ++

https://www.kff.org/medicare/a-profile-of-medicare-medicaid-enrollees-dual-eligibles/?utm_campaign=KFF%3A%20Medicare&utm_medium=email&_hsenc=p2ANqtz-9m9hLtBYtOQcEau2iArDtsVlONNPvAy-oBLMRqxfLEpVxyPoVXb6B_h42iLBM-AwGtuNT9OOo_B6sjrD0BnFQiMkcooQ&_hsmi=428570817&utm_content=428570817&utm_source=hs_email Two KFF Analyses Examine Characteristics, Spending, and Enrollment Data for Individuals Who Are Enrolled in Both Medicare and Medicaid Two new KFF analyses examine the latest data about the 12 million people who are enrolled in both Medicare and Medicaid – often referred to as dual-eligible individuals -- including their demographic, socioeconomic, and health characteristics and enrollment and spending for this population. Medicare is the primary payer and covers medical and post-acute care for dual-eligible individuals, while Medicaid provides wrap-around coverage by paying Medicare premiums and in most cases, cost-sharing and coverage of Medicaid benefits that are not provided through Medicare such as long-term care. One analysis finds that, compared with people only covered by Medicare, this population is more likely to report being in fair or poor health and need help with activities of daily living. Compared with Medicare beneficiaries without Medicaid, dual-eligible individuals are more likely to be younger, have lower incomes, and be people of color. The second analysis finds that dual-eligible individuals comprise disproportionately high shares of spending in Medicare and Medicaid relative to their enrollment. These costs to some extent reflect higher rates of chronic conditions among this group, and the analysis shows how Medicare and Medicaid spending increases as the number of chronic conditions does. The policy changes and reductions in future federal Medicaid spending that are a result of the 2025 budget reconciliation law are expected to reduce the number of low-income Medicare beneficiaries who are also enrolled in Medicaid. They could also affect the services that dual-eligible individuals receive if state Medicaid programs respond to increased fiscal pressures by reducing coverage of optional benefits. Contact: Chris Lee | 202.654.1403 | ChrisL@kff.org Five Key Facts About Spending and Enrollment for People with Medicare and Medicaid (Dual-Eligible Individuals) Authors: Abby Sachar, Abby Wolk, Alice Burns, and Jeannie Fuglesten Biniek Published: Jul 15, 2026 https://www.kff.org/medicaid/five-key-facts-about-spending-and-enrollment-for-people-with-medicare-and-medicaid-dual-eligible-individuals/?utm_campaign=KFF%3A%20Medicare&utm_medium=email&_hsenc=p2ANqtz-8uRO3ch6XsOTC7TOZapdjTJTR1RCDGXtLDzBlJKuLZVvvYeIiq1tP5gr68X7j-ItfU44IYwOC7fE8APGLs8gw6WT6e3Q&_hsmi=428570817&utm_content=428570817&utm_source=hs_email