Uninsured Adults in States that Did Not Expand Who Would Become Eligible for Medicaid under Expansion

Prior to the Affordable Care Act, Medicaid eligibility was limited to specific low-income groups, such as the elderly, people with disabilities, children, pregnant women, and some parents. The ACA expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($17,236 for an individual in 2019). As of April 2019, 14 states have not adopted the ACA Medicaid expansion. Across all non-expansion states, 4.4 million uninsured nonelderly adults would become eligible for Medicaid if all opted to expand their programs. The two-page fact sheets provide a snapshot with key data for those who would become eligible for Medicaid under expansion in non-expansion states.

Notes & Sources:

* Although Wisconsin has not expanded Medicaid under the ACA, the state provides Medicaid eligibility to adults up to the poverty level under a waiver. Wisconsin is the only state that has not adopted expansion that provides full Medicaid coverage to adults without dependent children. As a result, a fact sheet was not created for Wisconsin.

Medicaid Expansion Status: Kaiser Family Foundation State Health Facts, “Status of State Action on the Medicaid Expansion Decision,” accessed April 2019, https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/. Kaiser Family Foundation, Interactive Maps, “Status of State Medicaid Expansion Decisions: Interactive Map,” accessed April 2019, https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/.

Number of uninsured nonelderly adults who would become eligible for coverage under expansion, share of the uninsured nonelderly adult population, and parental status: Kaiser Family Foundation analysis of the 2017 American Community Survey (ACS), 1-Year Estimates.

2019 Medicaid Eligibility Levels: Tricia Brooks, Lauren Roygardner, Samantha Artiga, and Amrutha Ramaswamy, Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey (Washington, D.C.: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/.

Who Are Uninsured Adults Who Would Become Eligible for Medicaid if All States Expanded?: Kaiser Family Foundation analysis of the 2017 American Community Survey (ACS), 1-Year Estimates.

Where Do Uninsured Adults Who Would Be Eligible for Medicaid if All States Expanded Live? Kaiser Family Foundation analysis of the 2017 American Community Survey (ACS), 1-Year Estimates.

Geographic areas are defined by PUMAs, or Public-Use Microdata Areas. PUMAs are geographic areas defined as a collection of counties or tracts within counties with more than 100,000 people, based on the decennial census population counts. We use PUMA designations available on the public-use ACS microdata files.

What is the Potential Impact of Medicaid Expansion?: Larisa Antonisse, Rachel Garfield, Robin Rudowitz, and Samantha Artiga, The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review (Washington, D.C.: Kaiser Family Foundation, March 2018), https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/.

How Would the Medicaid Expansion be Financed?:

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