The uninsurance rate would decrease by 25% if the 10 states that haven’t expanded Medicaid did so, a new report shows. This represents 2.3 million people.
The Urban Institute report, published Monday, was supported by the Robert Wood Johnson Foundation. The estimates detailed in the report were based on a microsimulation model of the healthcare system that is “designed to estimate the cost and coverage effects of proposed healthcare policy options.”
The Affordable Care Act gave states the option to expand Medicaid to cover nonelderly adults with incomes up to 138% of the federal poverty level. The 10 states that have not expanded Medicaid are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.
The state that would see the biggest reduction in the uninsured rate by expanding Medicaid is Mississippi, where the uninsured rate would drop by 39.4%, or 100,000 people. Wisconsin would see the lowest reduction in the uninsured rate by 8.1%, or 23,000 people. While Wisconsin has not expanded Medicaid, it does have a waiver that provides coverage to adults without dependent children.
If the 10 states were to expand Medicaid, state spending on Medicaid would increase by $1.5 billion, or 3%, while federal spending on Medicaid would increase by $24 billion, or 17.5%. However, this spending would be offset by savings in uncompensated care, the researchers noted.
Additional findings from the report include:
- Women of reproductive age would see the uninsurance rate decrease by 31% if the remaining states expanded Medicaid, versus a decrease of 23.2% for older women and a decrease of 22.4% for men.
- The uninsurance rate for non-Hispanic Black women of reproductive age would drop by 51.3%
- Non-Hispanic Black adults would experience a 43.2% decrease in the uninsured rate, the largest of any racial or ethnic group.
- Young adults aged 19 to 24 would see a 32.4% decrease in the uninsured rate. This age group has the highest uninsured rate, with nearly one in five uninsured.
The report highlights the significant benefits that Medicaid expansion in these 10 states would have on health equity, among other areas, said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation.
“The coverage gap is perhaps the cruelest loophole in our fragmented coverage system. Expanding Medicaid eligibility in the remaining states would increase health equity, and generate health, social, economic, and fiscal benefits throughout the state,” Hempstead said in a news release. “We know from studies of other states that expanding Medicaid improves health outcomes for those who gain coverage, disproportionately populations of color, and additionally supports healthcare providers, especially in rural areas, and creates jobs.”
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