The ACA Medicaid Expansion Led to Widespread Reductions in Uninsurance Among Poor, Childless Adults

Doctor weighs patient in clinic or hospital examination room.

Medicaid expansion reduced uninsured rate of poor, childless adults by 47 percent.

 

 

The Issue

In 2014, 26 states (including the District of Columbia) expanded Medicaid eligibility to 138 percent of the federal poverty level—or a yearly income of about $16,000/$22,000 for a family of one/two. Researchers estimated the impact of the ACA Medicaid expansion on uninsured rates of poor, childless adult citizens, by age, gender, race, income, education, and health.

Key Findings

  • The uninsured rate of poor, childless adults decreased by 47.1 percent between 2013 and 2015 under the ACA.
  • Coverage gains were particularly large among adults in fair or poor health, with a 61.7 percent decline in their uninsured rate, compared to 39.6 percent for those in good or better health.
  • In 2015, 17.9 percent of those with incomes less than 50 percent of the federal poverty level were uninsured, compared to 54.5 percent in nonexpansion states.

 

Conclusion

Coverage gains found among people with health problems suggest that the ACA Medicaid expansion reached a group of vulnerable adults who likely had limited access to affordable coverage before the ACA.

About the Urban Institute

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