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The Cost of Not Expanding Medicaid

As states wrap up legislative sessions and make decisions about whether to implement the Medicaid expansion included in the Affordable Care Act (ACA), this new analysis highlights the implications of these decisions for coverage, state budgets and providers. The decisions by as many as 27 states not to adopt the Medicaid expansion will leave a many more uninsured; these states would also forgo billions in federal funds.

Analyzing the Impact of State Medicaid Expansion Decisions

One of the major vehicles in the Affordable Care Act (ACA) to increase health insurance coverage is an expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL). While the expansion was intended to be implemented in all states, as a result of the Supreme Court decision on the ACA, it is now effectively a state choice. States are divided about implementing the Medicaid expansion. This brief highlights 5 key ways that state decisions will shape the outcome of the Medicaid expansion. Without the Medicaid expansion there will be large gaps in coverage; significant implications for health care for the uninsured; consequences for certain regions and for people of color; coverage and fiscal implications for states, and implications for uncompensated care and hospitals.

A Discussion with Leading Medicaid Directors: As FY 2013 Ends, Looking toward Health Care Reform Implementation in 2014

The Kaiser Commission on Medicaid and the Uninsured convened a focus group discussion with Medicaid directors who serve on the Board of the National Association of Medicaid Directors (NAMD). The discussion focused on state progress and concerns about implementing the ACA including eligibility system changes and state action on the Medicaid expansion decision as well as activity around payment and delivery system reform, and other budget and enrollment trends. The discussion took place in May 2013. Nine Medicaid directors from the NAMD Board plus the Michigan Medicaid Director and NAMD staff participated in the discussion. The following states were represented: Arizona, California, Georgia, Indiana, Michigan, South Carolina, Tennessee, Virginia, Washington, and West Virginia.

Medicaid and Its Role in State/Federal Budgets & Health Reform

This chartpack from the Kaiser Commission on Medicaid and the Uninsured addresses five key questions about the Medicaid program. They include: What is Medicaid and what does it do? What does Medicaid cost and why? What is Medicaid’s role in state budgets? What is Medicaid’s role in the federal budget?…

Quick Take: Key Considerations in Evaluating the ACA Medicaid Expansion for States

A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges.  Following the June 2012 Supreme Court decision, states face a decision about whether to adopt…

The Impact of a 5 Percent Medicaid Expenditure Growth Cap: A State Level Analysis

This policy brief examines the projected impact of a 5% expenditure growth cap on Medicaid expenditures over the period 1996 to 2002. It highlights the differential implications that would result under this type of proposal.Policy Brief: The Impact of a Five Percent Medicaid Expenditure Growth Cap, A State Level Analysis

State Fiscal Conditions and Medicaid: 2014 Update

This issue brief provides an overview of Medicaid financing, Medicaid’s role in state budgets, the relationship between Medicaid and the economy and how the ACA and the Medicaid expansion could affect state budgets.

Health Coverage and Care in the South: A Chartbook

The South has faced longstanding disparities in health and health care, although significant variation exists between southern states. As a group, compared to those in other regions, Southerners are more likely to be uninsured, less likely to have access to needed health services, and more likely to experience a number of chronic health conditions. This chartbook provides key data on the demographic and economic characteristics of the southern population as well as their health status, health insurance coverage, and access to care today.