Some States to See Big Increases in Insured at Little or No Cost

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A new report, Medicaid Coverage and Spending in Health Reform: National and State-by-State Results, offers detailed analysis of the impact of the Medicaid expansion mandated by the Patient Protection and Affordable Care Act (PPACA) on state and federal Medicaid coverage and costs.

Medicaid expansion is expected to reduce the number of uninsured by 11.2 million people, approximately 45% of the uninsured adults making below 133% of the poverty level. Because of variation across states in the number of uninsured, policy, and fiscal capacity, the expansion will affect states differently.

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States with low coverage rates and high levels of uninsured will see large reductions (Alabama, 53.2%, and Texas, 49.4%). States with high numbers of uninsured and broader coverage, but none for childless adults, will also see big increases in insured (California 41.5% and New Jersey, 45.3%). The analysis shows that while there will be significant increases in coverage as well as federal spending, states will bear just a small part of the burden. PACCA provides 100% funding for all new eligible recipients in 2014–2016, 94% federal financing in 2018, 93% financing in 2019, and 90-% financing for 2020 and beyond. The report (#8076) is available on the Kaiser Family Foundation’s web site.