New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending

Issue Brief
  1. Total estimates do not include new federal funds or state costs for Missouri and Oklahoma, as these states already had plans to implement the expansion starting in July 2021 and thus do not face new state costs as a result of this policy. Further, we do not include new state expansion costs for Wisconsin, which has a waiver providing eligibility to childless adults earning up to the poverty level at the regular FMAP; thus, even with additional costs due to covering currently marketplace-eligible people, the state would likely see fiscal gain under expansion by moving waiver enrollees from the regular state match to the 90% expansion match.

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