Who Pays for America's Births (2025)
Medicaid pays for roughly two in five U.S. births, just behind private insurance, and for the majority of births to younger mothers.
Key findings
- Medicaid is the second-largest payer for U.S. births and a bigger force than most people realize. In 2025 it paid for 39.0% of births (1,399,424), behind private insurance at 53.1%.
- Self-pay (no insurance) covered 4.5% of births, a reminder that some families face the full cost of delivery out of pocket.
- Medicaid's role is defined by age: it paid for 63.2% of births to mothers under 25, versus 27.3% of births to mothers 35 and older.
- Together, Medicaid and private insurance cover the large majority of births; the rest fall to the military, other government programs, and self-pay.
Childbirth is among the most common reasons for a hospital stay, and who pays for it shapes the whole maternity system. This takes every 2025 U.S. birth with a reported payer and shows the split across Medicaid, private insurance, and other sources, then how it changes with the mother's age. These are exact counts from the near-census of birth records.
Payer for delivery, 2025
Source of payment for delivery
| Category | Share of births |
|---|---|
| Private insurance | 53.1% |
| Medicaid | 39% |
| Self-pay | 4.5% |
| CHAMPUS/TRICARE | 1.3% |
| Other | 1.1% |
| Other government | 1% |
| Indian Health Service | 0.1% |
By payer
| Payer | Births | Share |
|---|---|---|
| Private insurance | 1,907,637 | 53.1% |
| Medicaid | 1,399,424 | 39.0% |
| Self-pay | 161,906 | 4.5% |
| CHAMPUS/TRICARE | 45,072 | 1.3% |
| Other | 39,521 | 1.1% |
| Other government | 35,363 | 1.0% |
| Indian Health Service | 2,671 | 0.1% |
Among births with a reported payer. Payment source was not reported by every area in all years. Exact counts; no sampling margins of error.
Data Sources & Methodology
The figures on this page are computed directly from the source data below. Narrative text accompanies the figures but never generates them.
CDC/NCHS Natality (Births) Public Use File
- Vintage:
- 2025
- Access:
- BigQuery
- Cadence:
- annual
A near-census of U.S. births for the year, drawn from birth certificates. Each row is one birth, carrying the age, education, race and Hispanic origin, and marital status of the mother; prenatal care, pre-pregnancy BMI, and smoking; the delivery method, attendant, birth place, and payer; and the sex, birth weight, gestational age, plurality, and Apgar score of the infant. It supports analysis of who is being born and how, by maternal characteristics.
Every U.S. birth is registered on a birth certificate, which NCHS compiles into an annual public-use micro-file. Each record describes one birth and its mother.
The file covers essentially all registered births in the data year, not a probability sample. Statistics are exact counts; there are no sampling weights and no sampling margins of error.
To protect confidentiality, the public-use file omits state and county. Analyses here are national and by maternal and infant characteristics; state-level figures require CDC WONDER or the restricted-use file.
Gestational age uses the obstetric estimate (combined gestation); birth weight is in grams; delivery method distinguishes vaginal from cesarean; some reported items (education, payer, smoking) carry reporting flags for areas that had not adopted the 2003 certificate revision.
- No state or county geography in the public-use file.
- A few items (for example payer and smoking) were not reported by every area in early revision years; reporting flags identify coverage.
- The final annual file lags roughly a year; provisional counts via CDC WONDER are more timely but less detailed.
- Birth-certificate data depend on accurate completion by hospitals and reporting areas.
How these figures were produced
- Estimate type:
- Administrative near-census (exact counts)
- Weighting:
- None (not a weighted sample)
Suggested citation
Centers for Disease Control and Prevention, National Center for Health Statistics, 2025 Natality Public Use File. Analysis by Matt George, itsmattgeorge.com. Retrieved 2026-10-24.