While the federal government will pick up 100 percent of the costs for expanded Medicaid through 2016, states will be required to provide matching funds starting in 2017. By 2020, states would pick up 10 percent of costs for the expansion population, significantly less than the match on “traditional Medicaid,” which ranges from 26.4 percent in Mississippi to 50 percent in 13 states. Since half the states have so far chosen not to expand Medicaid, 5 million adults fall in the coverage gap between those eligible for traditional Medicaid and those eligible for subsidies for private insurance under the Affordable Care Act. The map at right shows the numbers of people in those states not expanding Medicaid who would otherwise be eligible for Medicaid under expansion. That includes nearly 4 million people who suffer from serious mental illness and substance abuse disorders fall in that gap, according to the American Mental Health Counselors Association. The percentage of uninsured adults—of the entire Medicaid expansion-eligible population—with mental health conditions that would be eligible for Medicaid under expansion ranges from 27 percent in Georgia to 62 percent in Indiana.
States that chose to expand Medicaid will see economic benefits because of that decision, according to data compiled and analyzed by the Kaiser Commission on Medicaid and the Uninsured. States that do not expand Medicaid forgo increased federal funds and associated new jobs.
State Economic Impact
States that chose not to expand Medicaid have another gap to consider—the jobs estimated to be generated by expansion that will be left on the table. The Kaiser Commission on Medicaid and the Uninsured analyzed data from state economic impact studies of the benefits of Medicaid expansion. The states used different analytical models to develop estimates on the economic impact and employment impact. The Kaiser Commission found Medicaid expansion would generate more state economic activity, such as increases in state output, gross state product, and state and local revenues. It also determined Medicaid expansion would have a positive effect on jobs and earnings.
Here are the expected number of new jobs based on the state impact studies Kaiser used in its analysis.