OBJECTIVES: The objective of this study was to determine the healthcare burden associated with breast cancer in the Medicaid population in terms of healthcare use and costs associated with the condition. METHODS: This study used the 2006-2008 Medicaid analytic extract files for 39 states in the United States.  The target population included recipients aged 18-64 years who were continuously enrolled in Medicaid during 2006-2008.  Breast cancer-related healthcare utilization during 2007-2008 in terms of inpatient, outpatient, and emergency room visits and treatment use was determined for women with breast cancer.  The excess healthcare burden attributable to breast cancer during 2007-2008 was determined by comparing all-cause healthcare use and costs between Medicaid recipients with breast cancer and a matched control group of recipients without breast cancer.  Generalized linear model with log link and Poisson distribution was used for multivariable comparison of all-cause costs between recipients with and without breast cancer. RESULTS: We identified 34,198 cases of breast cancer in the Medicaid population.  Breast cancer-related inpatient, outpatient, and emergency room visits were higher among women aged 30-39 and 40-49 years and ethnic minorities as compared to women aged 18-29, 50-59, and 60-64 years and whites respectively (p< 0.0001).  Hormonal therapy was the most commonly used treatment (26.8% and 28.1% of the recipients in 2007 and 2008 respectively).  The all-cause inpatient, outpatient, and emergency room visits were higher in recipients with breast cancer as compared to those without breast cancer (p< 0.0001).  In the multivariable analysis, recipients with breast cancer were found to have ~23.4% higher costs per year as compared to recipients without breast cancer (estimate: 0.2104, 95% confidence interval: 0.1955–0.2252). CONCLUSIONS: Breast cancer is associated with a considerable healthcare burden in the Medicaid population.  Healthcare use and costs were considerably greater among recipients with breast cancer as compared to those without breast cancer.