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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)
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.
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, http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act
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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