For the first time, the Commonwealth Fund has ranked states on how their residents enrolled in Medicare experience the program and its benefits. The report, released today, finds that Medicare’s impact is not uniform across the country: while core benefits are consistent, there are stark differences among states in beneficiaries’ ability to afford care, access doctors, and avoid unnecessary hospitalizations.
Marking its 60th year in 2025, Medicare provides essential health coverage to more than 68 million Americans, including nearly all adults age 65 and older and millions of people with disabilities. Before Medicare, these groups were far more likely to be uninsured and unable to access needed care.
According to the State Scorecard on Medicare Performance: How Medicare Is Working for Its Beneficiaries, Medicare enrollees in some states are better served than others. Although Medicare is a federal program, access to care and health outcomes are shaped by a mix of state and local factors — such as the strength of a state’s health system, the affordability of supplemental coverage, and the structure of private Medicare Advantage and drug plans — all of which vary across the country.