A decrease in the uninsurance rate by 25% could be witnessed if the remaining 10 states in the US that have not yet expanded Medicaid decided to do so. This would extend coverage to approximately 2.3 million more people, as a recent report indicates.
The report, produced by the Urban Institute and supported by the Robert Wood Johnson Foundation, utilizes a microsimulation model. This model is designed to estimate the cost and coverage effects of proposed healthcare policies. According to these estimates, Mississippi carries the potential for the largest reduction in uninsured citizens, with a possibility of decreasing the uninsured rate by 39.4%. This translates to extending coverage to an additional 100,000 people.
The Affordable Care Act had previously offered states the opportunity to broaden Medicaid coverage for nonelderly adults with incomes at or below 138% of the federal poverty level. The 10 states that have withheld expansion include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. Wisconsin, despite not having expanded Medicaid, maintains a waiver that provides coverage to childless adults.
Should these ten states opt for Medicaid expansion, an increase in state Medicaid spending of $1.5 billion or 3%, and federal Medicaid spending by $24 billion or 17.5% is projected. While the numbers look substantial, the researchers underlined that this cost increase would be counterbalanced by savings in uncompensated healthcare.
In addition to the overarching trends, the report also outlines several specific demographics that would benefit greatly from Medicaid expansion:
- Women of reproductive age are projected to see their uninsurance rate decrease by 31%.
- The uninsured rate for non-Hispanic black women of reproductive age would plunge by 51.3%.
- Non-Hispanic black adults would see a 43.2% decrease in the uninsured rate, the highest among any racial or ethnic group.
- Young adults between the ages of 19 and 24 would experience a 32.4% decrease in the uninsured rate. This age group currently has the highest uninsured rate, with nearly one in five uninsured.
Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, emphasizes that Medicaid expansion in these ten states would significantly benefit health equity. She elaborates, “The coverage gap is 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. We know from studies of other states that expanding Medicaid improves health outcomes for those who gain coverage, predominantly populations of color, and it also supports healthcare providers, especially those in rural areas, and leads to job creation.”