Analysis: Medicaid to cover more Americans, reduce uninsured rates across all states

WASHINGTON The expansion of Medicaid under the new health-reform law significantly will increase the number of people covered by the program and will markedly reduce the uninsured in states across the country, with the federal government picking up the overwhelming majority of the cost, according to a state-by-state analysis released Wednesday by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

The analysis, performed by John Holahan and Irene Headen of the Urban Institute for the foundation, is among the first to show for all 50 states and the District of Columbia the distribution of new Medicaid enrollees and costs, as well as the impact on the uninsured. Health reform will offer Medicaid coverage to millions of low-income adults for the first time and help establish a national floor for Medicaid eligibility that sharply contrasts with the wide variation in eligibility across state Medicaid programs today.

States with large uninsured populations today are expected to see the biggest increases in the numbers of people who obtain health coverage through Medicaid. California and Texas, for example, two states with considerable numbers of uninsured residents, are each projected to see 1.4 million fewer uninsured adults in 2019 due to the Medicaid expansion, with the federal government covering 95% of the cost in Texas and 94% in California.

“For a relatively small investment of state dollars, states could see huge returns in terms of additional coverage for their lowest income residents — with federal dollars covering the bulk of the bill,” stated Diane Rowland, EVP of the foundation and executive director of the KCMU.

Nationally, the analysis projects that Medicaid enrollment will climb by 15.9 million more people by 2019 than it otherwise would have, and the number of uninsured will fall by more than 11 million. The cost of the Medicaid expansion between 2014 and 2019 would be jointly financed with the federal government paying $443.5 billion (or 95.4 % of the total cost) and the states contributing $21.2 billion.