Medicare and Medicaid are not exclusive. They call it "dual eligible". (PDF WARNING) https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-

Medicare and Medicaid are not exclusive. They call it "dual eligible". (PDF WARNING) https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/MMCO_Factsheet.pdf https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-... This lists 20% of Medicare and 15% of Medicaid enrolled are dual eligible. So that's somewhere between 10.2 and 12.2 million lower, using your numbers. (And yes, those numbers are obviously off somewhere, since the two should match. But it's good enough and I'm not sure it's even possible to track down the actual numbers used in the given link.)