What Is the Result of States Not Expanding Medicaid?

An issue brief by Urban Institute researchers illustrates the economic impact in states where Medicaid is not expanding.

In the 24 states that have not expanded Medicaid, 6.7 million residents are projected to remain uninsured in 2016 as a result.

These states are forgoing $423.6 billion in federal Medicaid funds from 2013 to 2022, which will lessen economic activity and job growth.

Hospitals in these 24 states are also slated to lose a $167.8 billion (31%) boost in Medicaid funding that was originally intended to offset major cuts to their Medicare and Medicaid reimbursement.

The authors note that opting to expand Medicaid would generate state savings and revenues exceeding the cost of expansion.

Key Findings

  • States that have not expanded Medicaid will miss out on $423.6 billion in federal funding between 2013 and 2022.

  • The decision of state leaders not to expand Medicaid also means their local hospitals will collectively forgo $167.8 billion in Medicaid reimbursement payments over the same timeframe.

  • Based on analyses of state budgets, for every $1 a state spends expanding Medicaid, $13.41 in federal funding flows into the state.

  • In total, hospitals in states not expanding stand to forgo $167.8 billion in reimbursement funding from 2013 to 2022.