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Given all the benefits of Medicaid, you’d think that expanding the program would be a no-brainer. Sadly, that’s not the case in far too many states. Here’s why.

Under the Affordable Care Act (ACA), states can expand their Medicaid program so that it’s available to more people — to anyone whose income is below 138% of the federal poverty level. Without expansion, Medicaid eligibility is narrow and only covers small segments of low-income communities. Medicaid  is paid for jointly by the federal government and states across the country. Expanding Medicaid means:

  • States pay a fraction of the cost because the federal government foots the vast majority of the bill,

  • States can save hundreds of millions of dollars in health care costs by helping people access preventive care (helping clinicians diagnose and treat health conditions earlier, before they become more severe and costly), and

  • Increased state revenue and local job growth.

What's Stopping States from Expanding Medicaid

Under the Affordable Care Act, 32 states including Washington D.C. expanded Medicaid as of December 2016. These expansions helped nearly 17 million people gain Medicaid coverage since January 2014.  A 2015 estimate found that if every state expanded its Medicaid program, together they could insure more than  4 million more people. And that could radically improve people’s lives.

So what’s stopping 19 states from expanding Medicaid? It’s not money. It’s not logic. It’s political games. All of which means there’s work still to be done to bring this lifesaving program to the millions of Americans who are eligible for it.

This map from the Kaiser Family Foundation shows where expansion needs to start:


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