The Issue

Ten states—Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming—have not expanded Medicaid eligibility under the Affordable Care Act to individuals with incomes up to 138% of the federal poverty level.

Key Findings

• Researchers find that the uninsurance rate would drop by 25% if the 10 states expanded their Medicaid programs.
• Women of reproductive age would see a large reduction in uninsurance (a drop of 31%), compared to older women (drop of 23.2%) and men (drop of 22.4%).  
  • Non-Hispanic Black women of reproductive age would see a 51.3% reduction in uninsurance.
    
• Non-Hispanic Black adults would see the largest reduction in the uninsured rate of any racial or ethnic group (43.2% reduction).
  
• Young adults ages 19 to 24, the age group with the highest uninsured rate, with nearly one in five individuals uninsured (19.9%) would see the greatest decrease in the rate of uninsurance (a drop of 32.4%). 
  
• Many states that previously expanded Medicaid found new spending on expansion is outweighed by long-term savings in healthcare expenditures and new revenue.
  
  • State spending on Medicaid in the remaining 10 states would increase by $1.5 billion (an increase of 3%).  
    
  • Federal spending on Medicaid in these states would increase by about $24 billion (an increase of 17.5%). 
    

Conclusion

Researchers conclude that in addition to reducing the number of uninsured, states that have expanded Medicaid see significant health and economic benefits that impact all residents, not just those who would gain coverage. 

About the Author/Grantee

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.