Economic and Fiscal Trends in Expansion and Non-Expansion States: What We Know Leading Up to 2014
Executive Summary
- View Exhibits
- Exhibit 1.1: Over half of states have adopted the Medicaid expansion.
- Exhibit 1.2: The typical non-expansion state has historically had higher rates of poverty.
- Exhibit 1.3: The typical non-expansion state had a higher uninsured rate prior to the major ACA coverage expansions than the typical expansion state.
- Exhibit 1.4: The typical expansion state has greater tax capacity than the typical non-expansion state, regardless of measure.
- Exhibit 1.5: The typical expansion state has historically collected more per capita in state and local taxes.
- Exhibit 1.6: The typical expansion state has raised more tax revenue as a share of total taxable resources than the typical non-expansion state.
- Exhibit 1.7: The typical expansion state spent more per capita on Medicaid and K-12 Education than the typical non-expansion state.
- Exhibit 1.8: The typical expansion state has historically had a higher share of employment in the health sector.
How Do Expansion And Non-Expansion States Compare? - Demographics
- View Exhibits
- Exhibit 2.1: Children comprise a quarter of the population; however, the elderly are growing at a much faster pace.
- Exhibit 2.2: The shares of the population for children are declining and the shares for the elderly are growing in both groups.
- Exhibit 2.3: The typical expansion state has a higher median household income; however, median income remains below 2000 levels.
- Exhibit 2.4: There is variation within both groups in terms of the median household income.
- Exhibit 2.5: The typical non-expansion state has historically had higher rates of poverty.
- Exhibit 2.6: Within expansion and non-expansion states, there is a notable amount of variation in poverty rates.
- Exhibit 2.7: Prior to the major ACA coverage expansions, over 13% of Americans were uninsured.
- Exhibit 2.8: The typical non-expansion state had a higher uninsured rate prior to the major ACA coverage expansions than the typical expansion state.
How Do Expansion And Non-Expansion States Compare? - Revenue and Tax Capacity
- View Exhibits
- Exhibit 3.1: Both groups saw sharp declines in revenues during the Great Recession, but the typical expansion state has recovered quicker.
- Exhibit 3.2: The typical expansion state has greater tax capacity than the typical non-expansion state, regardless of measure.
- Exhibit 3.3: The typical expansion state has historically had higher tax capacity; the difference has been growing over time.
- Exhibit 3.4: The typical expansion state has historically collected more per capita in state and local taxes.
- Exhibit 3.5: The typical expansion state has raised more tax revenue as a share of total taxable resources than the typical non-expansion state.
- Exhibit 3.6: The most common sources of state and local tax revenue nationally are property, general sales and personal income taxes.
- Exhibit 3.7: The typical non-expansion state relies more heavily on general sales tax revenues than the typical expansion state.
- Exhibit 3.8: The typical expansion state has acted to increase taxes since the recession while the typical non-expansion state has cut taxes.
How Do Expansion And Non-Expansion States Compare? - State Budgets
- View Exhibits
- Exhibit 4.1: State and local government spending declined in the years following the recession.
- Exhibit 4.2: The typical expansion state spends more per capita than the typical non-expansion state.
- Exhibit 4.3: There is wide variation across both groups in terms of state and local government expenditures per capita.
- Exhibit 4.4: Nationally, states and local governments spend the most on K-12 education per capita, followed by Medicaid and higher education.
- Exhibit 4.5: The typical expansion state spent more per capita on Medicaid and K-12 Education than the typical non-expansion state.
- Exhibit 4.6: Medicaid spending continued to grow during the recession; health and hospital spending slowed and K-12 education spending declined.
- Exhibit 4.7: The typical expansion state saw stronger Medicaid spending growth, smaller cuts to K-12 education since the start of the Recession.
How Do Expansion And Non-Expansion States Compare? - Employment
- View Exhibits
- Exhibit 5.1: The typical expansion state has a higher rate of unemployment, but unemployment has been recently declining for both groups.
- Exhibit 5.2: There is wide variation in unemployment rates for both groups.
- Exhibit 5.3: Nationally, total employment has fluctuated with changing economic conditions, but health-related employment has remained strong.
- Exhibit 5.4: Nationally, health-related employment has been growing as a share of total employment since 2000.
- Exhibit 5.5: The typical expansion state has historically had a higher share of employment in the health sector.
- Exhibit 5.6: All states saw strong growth in health-related employment; however growth in this sector slowed for both groups in 2008-2013.
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Exhibit 1.1
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Exhibit 2.1
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Exhibit 3.1
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Exhibit 4.1
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Exhibit 5.1
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