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3.7 million people would gain health coverage in 2023 if the remaining 12 states were to expand Medicaid eligibility
3.7 million people would gain health coverage in 2023 if the remaining 12 states were to expand Medicaid eligibility
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Urban Institute research report
- Author(s):
- Buettgens, Matthew, author
Ramchandani, Urmi, author - Contributor(s):
- Robert Wood Johnson Foundation, issuing body.
Urban Institute, issuing body. - Publication:
- Washington, DC : Urban Institute, July 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Equity -- economics
Health Policy
Insurance, Health -- economics
Medicaid -- legislation & jurisprudence
Medically Uninsured -- statistics & numerical data
Poverty -- economics
Social Mobility
United States - Genre(s):
- Technical Report
- Abstract:
- States have the option to expand Medicaid eligibility to nonelderly people with incomes up to 138 percent of the federal poverty level (FPL) under the Affordable Care Act (ACA).1 At the time of writing, only 12 states have not done so: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming. Among adults in nonexpansion states, except for Wisconsin, only parents with very low incomes can be eligible Medicaid with full benefits.2 Wisconsin is unique in that it extended Medicaid eligibility to adults with incomes up to 100 percent FPL in 2014, without accepting the ACA’s Medicaid expansion. Among the nonexpansion states, the highest eligibility thresholds for parents are in Tennessee (88 percent of FPL) and South Carolina (67 percent of FPL).3 The remaining nine expansion states have thresholds at or below 50 percent of FPL; the lowest thresholds are in Texas (16 percent of FPL) and Alabama (18 percent of FPL). People with incomes below 100 percent of FPL are also ineligible for Marketplace premium tax credits (PTCs).4 Thus, many uninsured adults with incomes below 100 percent of FPL in nonexpansion states are caught in a coverage gap, qualifying for neither Medicaid nor PTCs to purchase Marketplace coverage. They generally have no affordable health insurance options. Additionally, people with incomes between 100 and 138 percent of FPL may fall into an assistance gap and be ineligible for tax credits if they have an affordable offer of other coverage.5 Medicaid has no such requirement for eligibility, so these people would gain eligibility for assistance if their states were to expand Medicaid. This report updates a series of analyses that used the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM) to estimate the impact of Medicaid expansion, most recently Buettgens (2021) and Simpson (2020). Here we assume states have fully resumed normal Medicaid eligibility processing after the expiration of the US Department of Health and Human Services’ COVID-19 public health emergency (Buettgens and Green 2022) and that enhanced Marketplace PTCs under the American Rescue Plan Act (ARPA) expire in 2023 (Buettgens, Banthin, and Green 2022), as they are slated to under current law. We estimate new Medicaid enrollment, as well as the resulting decline in the number of uninsured people, assuming all nonexpansion states were to expand eligibility. We show how this would affect different age, gender, and racial and ethnic groups. We also consider the costs of Medicaid expansion.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (vi, 26 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918471183306676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918471183306676