If the 21 states that have not expanded Medicaid under the Patient Protection and Affordable Care Act as of April 2015 were to do so, they would experience an increase in Medicaid enrollment, fewer uninsured people, an increase in Medicaid spending and reductions in uncompensated care, according to an analysis conducted by the Urban Institute for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured.
Specifically, the following would occur if the 21 states opted for Medicaid expansion, according to the analysis.
1. With no change in state expansion decisions, it is estimated that in 2016, 17.4 million nonelderly people will be enrolled in Medicaid in the 21 nonexpansion states. Were these states to expand Medicaid, enrollment would go up by 40 percent to 24.3 million.
2. The PPACA, even without Medicaid expansion, is expected to reduce the number of uninsured in the 21 states to 14.1 million in 2016. Were the 21 states to expand Medicaid, the number of uninsured would decline further to 9.8 million.
3. From 2015 to 2024, the Medicaid programs in the 21 nonexpansion states are projected to spend $2.6 trillion with no change in their expansion status, with $1.6 trillion funded by the federal government and $971 billion funded by the states. Federal Medicaid spending from 2015 to 2024 would rise by 30 percent while state spending would rise by 4 percent if the 21 states expanded Medicaid.
4. Savings on reduced uncompensated care would offset between 13 percent and 25 percent of that additional state spending.
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