What Coverage and Financing is at Risk Under a Repeal of the ACA Medicaid Expansion?
| Appendix Table 1: Medicaid Eligibility Limits for Parents and Other Adults as a Percent of the Federal Poverty Level | ||||||
| State | Parents (in a family of three) |
Other Adults (for an individual) |
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| 2013 (Pre-ACA) | 2016 | 2013 (Pre-ACA) | 2016 | |||
| Federal Poverty Level | $19,530 | $20,160 | $11,490 | $11,880 | ||
| Alabama | 23% | 18% | 0% | 0% | ||
| Alaska | 78% | 143% | 0% | 138% | ||
| Arizona | 106% | 138% | 100% | 138% | ||
| Arkansas | 16% | 138% | 0% | 138% | ||
| California | 106% | 138% | 0% | 138% | ||
| Colorado | 106% | 138% | 20% | 138% | ||
| Connecticut | 191% | 155% | 70% | 138% | ||
| Delaware | 120% | 138% | 110% | 138% | ||
| District of Columbia | 206% | 221% | 211% | 215% | ||
| Florida | 56% | 34% | 0% | 0% | ||
| Georgia | 48% | 37% | 0% | 0% | ||
| Hawaii | 138% | 138% | 100% | 138% | ||
| Idaho | 37% | 26% | 0% | 0% | ||
| Illinois | 139% | 138% | 0% | 138% | ||
| Indiana | 24% | 139% | 0% | 139% | ||
| Iowa | 80% | 138% | 0% | 138% | ||
| Kansas | 31% | 38% | 0% | 0% | ||
| Kentucky | 57% | 138% | 0% | 138% | ||
| Louisiana | 24% | 138% | 0% | 138% | ||
| Maine | 200% | 105% | 0% | 0% | ||
| Maryland | 122% | 138% | 0% | 138% | ||
| Massachusetts | 133% | 138% | 0% | 138% | ||
| Michigan | 64% | 138% | 0% | 138% | ||
| Minnesota | 215% | 138% | 75% | 138% | ||
| Mississippi | 29% | 27% | 0% | 0% | ||
| Missouri | 35% | 22% | 0% | 0% | ||
| Montana | 54% | 138% | 0% | 138% | ||
| Nebraska | 58% | 63% | 0% | 0% | ||
| Nevada | 84% | 138% | 0% | 138% | ||
| New Hampshire | 47% | 138% | 0% | 138% | ||
| New Jersey | 200% | 138% | 0% | 138% | ||
| New Mexico | 85% | 138% | 0% | 138% | ||
| New York | 150% | 138% | 100% | 138% | ||
| North Carolina | 47% | 44% | 0% | 0% | ||
| North Dakota | 57% | 138% | 0% | 138% | ||
| Ohio | 96% | 138% | 0% | 138% | ||
| Oklahoma | 51% | 44% | 0% | 0% | ||
| Oregon | 39% | 138% | 0% | 138% | ||
| Pennsylvania | 58% | 138% | 0% | 138% | ||
| Rhode Island | 181% | 138% | 0% | 138% | ||
| South Carolina | 89% | 67% | 0% | 0% | ||
| South Dakota | 50% | 52% | 0% | 0% | ||
| Tennessee | 122% | 101% | 0% | 0% | ||
| Texas | 25% | 18% | 0% | 0% | ||
| Utah | 42% | 45% | 0% | 0% | ||
| Vermont | 191% | 138% | 160% | 138% | ||
| Virginia | 30% | 39% | 0% | 0% | ||
| Washington | 71% | 138% | 0% | 138% | ||
| West Virginia | 31% | 138% | 0% | 138% | ||
| Wisconsin | 200% | 100% | 0% | 100% | ||
| Wyoming | 50% | 57% | 0% | 0% | ||
| NOTES: The Federal Poverty Level (FPLs) is for the 48 contiguous states and DC. Alaska and Hawaii have separate FPLs. Eligibility limits are for full Medicaid benefits; waiver programs that provide more limited benefits or state-funded programs are not included. Parent limits are based on a family of three; other adults are based on an individual. For parent limits that are based on a dollar threshold, the reported values are FPL equivalents. 2013 levels take states’ earnings disregards, when applicable, into account. 2016 limits include a disregard equal to five percentage points of the FPL. SOURCE: Based on results from national surveys conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, updated to reflect Medicaid expansion decisions as of November 2016. |
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| Appendix Table 2: Medicaid Enrollment (rounded to nearest 100), 2015 | ||||||
| State | Expanded Medicaid by December 31, 2015 | Medicaid Enrollment | Expansion Group Enrollment | Expansion Group – Newly Eligible Enrollment |
Expansion Group – Not Newly Eligible Enrollment |
|
| Alabama | No | 1,055,900 | 0 | 0 | 0 | |
| Alaska* | Yes | 130,000 | 8,500 | 8,500 | 0 | |
| Arizona | Yes | 1,873,400 | 413,000 | 105,700 | 307,200 | |
| Arkansas | Yes | 1,183,700 | 291,600 | 266,700 | 39,500 | |
| California^ | Yes | 13,381,700 | 3,466,100 | 3,466,100 | 0 | |
| Colorado | Yes | 1,209,900 | 347,800 | 346,200 | 1,600 | |
| Connecticut | Yes | 840,600 | 201,000 | 187,000 | 19,600 | |
| Delaware | Yes | 212,200 | 61,300 | 10,100 | 51,600 | |
| District of Columbia | Yes | 249,000 | 62,000 | 62,000 | 0 | |
| Florida | No | 4,080,200 | 0 | 0 | 0 | |
| Georgia | No | 1,868,200 | 0 | 0 | 0 | |
| Hawaii | Yes | 313,800 | 107,500 | 34,300 | 74,100 | |
| Idaho | No | 303,300 | 0 | 0 | 0 | |
| Illinois | Yes | 3,014,000 | 671,100 | 654,400 | 25,200 | |
| Indiana* | Yes | 1,247,400 | 361,700 | 222,400 | 141,400 | |
| Iowa | Yes | 587,100 | 146,300 | 136,100 | 10,300 | |
| Kansas | No | 383,300 | 0 | 0 | 0 | |
| Kentucky | Yes | 1,283,800 | 439,000 | 439,000 | 0 | |
| Louisiana* | No | 1,462,800 | 0 | 0 | 0 | |
| Maine | No | 279,000 | 0 | 0 | 0 | |
| Maryland | Yes | 1,186,300 | 260,200 | 260,200 | 0 | |
| Massachusetts | Yes | 2,037,600 | 410,900 | 0 | 410,900 | |
| Michigan | Yes | 2,311,500 | 613,800 | 579,400 | 37,400 | |
| Minnesota | Yes | 1,194,200 | 208,500 | 207,700 | 900 | |
| Mississippi | No | 746,200 | 0 | 0 | 0 | |
| Missouri | No | 962,000 | 0 | 0 | 0 | |
| Montana* | No | 139,000 | 0 | 0 | 0 | |
| Nebraska | No | 237,000 | 0 | 0 | 0 | |
| Nevada | Yes | 566,400 | 187,100 | 187,100 | 0 | |
| New Hampshire | Yes | 188,000 | 49,000 | 48,800 | 400 | |
| New Jersey | Yes | 1,633,900 | 532,900 | 532,900 | 0 | |
| New Mexico | Yes | 840,100 | 235,400 | 235,400 | 0 | |
| New York | Yes | 6,657,700 | 2,276,900 | 285,600 | 1,993,000 | |
| North Carolina | No | 1,975,200 | 0 | 0 | 0 | |
| North Dakota^ | Yes | N/A | N/A | N/A | N/A | |
| Ohio | Yes | 3,078,200 | 665,900 | 618,200 | 47,600 | |
| Oklahoma | No | 760,800 | 0 | 0 | 0 | |
| Oregon | Yes | 1,113,800 | 546,400 | 474,800 | 71,600 | |
| Pennsylvania | Yes | 2,670,400 | 603,300 | 548,000 | 55,400 | |
| Rhode Island | Yes | 279,900 | 59,300 | 59,300 | 0 | |
| South Carolina | No | 1,219,600 | 0 | 0 | 0 | |
| South Dakota | No | 109,800 | 0 | 0 | 0 | |
| Tennessee | No | 1,654,200 | 0 | 0 | 0 | |
| Texas | No | 4,338,400 | 0 | 0 | 0 | |
| Utah | No | 327,700 | 0 | 0 | 0 | |
| Vermont | Yes | 207,100 | 60,700 | 0 | 60,700 | |
| Virginia | No | 992,800 | 0 | 0 | 0 | |
| Washington | Yes | 1,813,800 | 592,100 | 577,400 | 15,600 | |
| West Virginia | Yes | 554,600 | 175,000 | 175,000 | 0 | |
| Wisconsin | No | 1,213,000 | 0 | 0 | 0 | |
| Wyoming | No | 72,600 | 0 | 0 | 0 | |
| Total | 30 expanded by 12/31/15 | 76,041,000 | 14,054,100 | 10,728,200 | 3,363,900 | |
| NOTES: *Medicaid expansion column reflects if states expanded Medicaid by December 31, 2015. Alaska and Indiana expanded mid-2015 (Alaska on 9/1/15 and Indiana on 2/1/15). Louisiana and Montana have since expanded Medicaid (Louisiana on 7/1/16 and Montana on 1/1/16). ^California and North Dakota data were unavailable from CMS. California data were obtained from California Department of Health Report. This report does not distinguish newly eligible and not newly eligible adults, but because California did not provide full benefits to the new eligibility group prior to expansion, we classified all California beneficiaries as newly eligible. Enrollment from both MBES and CA DHCS report is reported for each month. In an effort to take into account that some beneficiaries are enrolled for only part of the year, maximum monthly enrollment for each state is used to estimate total annual enrollment. Due to rounding, state totals may not sum to national total. SOURCE: Kaiser Commission on Medicaid and the Uninsured analysis of Medicaid spending and enrollment data collected from the Medicaid Budget and Expenditure System (MBES), Centers for Medicare and Medicaid Services (accessed November 2016) and California Department of Health Care Services report “Medi-Cal Monthly Enrollment Fast Facts, June 2016”. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/enrollment-mbes/index.html. http://www.dhcs.ca.gov/dataandstats/statistics/Documents/Fast_Facts_June_2016_ADA.pdf. State expansion status available at “Status of State Action on the Medicaid Expansion Decision,” KFF State Health Facts, https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act |
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| Appendix Table 3: Medicaid Spending (in millions), January 2014-June 2015 | ||||||
| State | Total Medicaid Spending | Traditional Medicaid – Federal Spending |
Traditional Medicaid – State Spending |
Expansion Group – Federal Spending |
Expansion Group – State Spending |
|
| Alabama | $7,816 | $5,418 | $2,398 | N/A | N/A | |
| Alaska* | $2,400 | $1,408 | $992 | N/A | N/A | |
| Arizona | $14,613 | $8,211 | $3,542 | $2,512 | $349 | |
| Arkansas | $8,018 | $4,516 | $1,829 | $1,673 | $0 | |
| California | $105,621 | $42,732 | $41,637 | $21,252 | $0 | |
| Colorado | $9,977 | $4,191 | $4,039 | $1,743 | $4 | |
| Connecticut | $11,320 | $4,816 | $4,650 | $1,817 | $37 | |
| Delaware | $2,680 | $1,143 | $957 | $469 | $111 | |
| District of Columbia | $3,609 | $2,198 | $944 | $464 | $3 | |
| Florida | $31,790 | $19,127 | $12,662 | N/A | N/A | |
| Georgia | $14,720 | $9,964 | $4,756 | N/A | N/A | |
| Hawaii | $2,986 | $1,230 | $1,110 | $599 | $47 | |
| Idaho | $2,600 | $1,869 | $731 | N/A | N/A | |
| Illinois | $26,478 | $11,832 | $11,224 | $3,370 | $52 | |
| Indiana* | $13,992 | $8,904 | $4,345 | $610 | $133 | |
| Iowa | $6,573 | $3,226 | $2,359 | $967 | $21 | |
| Kansas | $4,409 | $2,516 | $1,894 | N/A | N/A | |
| Kentucky | $12,591 | $6,415 | $2,687 | $3,488 | $0 | |
| Louisiana* | $10,956 | $6,861 | $4,095 | N/A | N/A | |
| Maine | $3,765 | $2,351 | $1,414 | N/A | N/A | |
| Maryland | $14,465 | $6,117 | $5,943 | $2,405 | $0 | |
| Massachusetts | $22,980 | $10,465 | $10,100 | $1,858 | $556 | |
| Michigan | $21,984 | $12,507 | $6,354 | $3,081 | $42 | |
| Minnesota | $14,821 | $6,476 | $6,310 | $2,034 | $2 | |
| Mississippi | $7,689 | $5,682 | $2,007 | N/A | N/A | |
| Missouri | $13,861 | $8,793 | $5,067 | N/A | N/A | |
| Montana* | $1,741 | $1,179 | $562 | N/A | N/A | |
| Nebraska | $2,776 | $1,509 | $1,266 | N/A | N/A | |
| Nevada | $4,124 | $2,004 | $1,092 | $1,029 | $0 | |
| New Hampshire | $2,278 | $1,060 | $1,020 | $198 | $1 | |
| New Jersey | $20,607 | $8,795 | $8,229 | $3,583 | $0 | |
| New Mexico | $6,983 | $3,693 | $1,560 | $1,730 | $0 | |
| New York | $86,485 | $37,759 | $36,143 | $9,265 | $3,317 | |
| North Carolina | $18,669 | $12,379 | $6,290 | N/A | N/A | |
| North Dakota | $1,273 | $557 | $535 | $179 | $2 | |
| Ohio | $31,119 | $17,554 | $9,809 | $3,676 | $79 | |
| Oklahoma | $7,388 | $4,750 | $2,638 | N/A | N/A | |
| Oregon | $11,559 | $5,284 | $2,717 | $3,559 | $0 | |
| Pennsylvania | $33,939 | $17,677 | $15,479 | $757 | $26 | |
| Rhode Island | $3,659 | $1,518 | $1,481 | $660 | $0 | |
| South Carolina | $8,809 | $6,240 | $2,569 | N/A | N/A | |
| South Dakota | $1,204 | $689 | $515 | N/A | N/A | |
| Tennessee | $12,895 | $8,443 | $4,452 | N/A | N/A | |
| Texas | $48,556 | $28,854 | $19,702 | N/A | N/A | |
| Utah | $3,266 | $2,311 | $955 | N/A | N/A | |
| Vermont | $2,382 | $1,162 | $877 | $276 | $68 | |
| Virginia | $11,685 | $5,936 | $5,750 | N/A | N/A | |
| Washington | $16,420 | $5,914 | $5,702 | $4,751 | $52 | |
| West Virginia | $5,349 | $3,282 | $1,311 | $755 | $0 | |
| Wisconsin | $11,569 | $6,895 | $4,675 | N/A | N/A | |
| Wyoming | $817 | $418 | $399 | N/A | N/A | |
| Total | $748,267 | $384,829 | $279,775 | $78,761 | $4,902 | |
| NOTE: *Alaska and Indiana expanded mid-2015 (Alaska on 9/1/15 and Indiana on 2/1/15). Louisiana and Montana have since expanded Medicaid (Louisiana on 7/1/16 and Montana on 1/1/16). Due to rounding, spending amounts may not sum to subtotals or national total. SOURCE: Kaiser Commission on Medicaid and the Uninsured analysis of Medicaid spending data collected from the Medicaid Budget and Expenditure System (MBES), Centers for Medicare and Medicaid Services (accessed November 2016). https://www.medicaid.gov/medicaid/financing-and-reimbursement/state-expenditure-reporting/expenditure-reports/index.html |
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