States Refusing Medicaid Expansion Could Miss Out

States’ refusal to expand their Medicaid programs could cost billions of dollars over the next 10 years, and those costs are staggering.

A recent study showed that Texas, for instance, will relinquish $9.2 billion in federal funding in 2022. Florida will miss out on $5 billion, while Tennessee and Indiana risk $2 billion in funding by declining to expand Medicaid. Georgia, Missouri, North Carolina, and Virginia will also forfeit more than $2 billion in federal funding, and Louisiana, Oklahoma, and Wisconsin will miss out on more than $1 billion.

“If adopted by all states, the Medicaid expansion is expected to provide health insurance to as many as 21.3 million Americans by 2022, improving their access to care and financial protection,” said study authors Sherry Glied and Stephanie Ma of New York University’s Wagner Graduate School of Public Service. “For states, this expansion in coverage will mean reductions in state uncompensated care costs and in spending for some state programs. It will also mean substantial changes in federal funding.”

The authors argue that states that fail to see the health and health-system benefits of Medicaid expansion might see the value additional federal funding would have for their states’ economies.

“For example, the increase in federal funding in 2022 from participating in the Medicaid expansion is roughly equivalent to one-quarter of the total value of federal procurements for that year and more than twice as much as all federal funding for highways,” wrote the authors. “In most cases, the investment to attract this federal funding is modest. For example, the gain in federal funds in Louisiana from participating in Medicaid is nearly twice as large as annual federal defense procurement spending in the state.”

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New State-by-State Analysis: States Rejecting Medicaid Expansion Under the Affordable Care Act Are Costing Their Taxpayers Billions [Commonwealth Fund]