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Census Data Show States Not Expanding Medicaid Falling Further Behind

States that have adopted health reform’s Medicaid expansion had a much lower uninsured rate in 2015 than states that haven’t, new Census Bureau data show.  Moreover, the gap keeps widening.

Some 7.2 percent of the people in the 28 states (including the District of Columbia) that expanded Medicaid by January 2015 lacked health insurance that year, compared with 12.3 percent in the 23 non-expansion states, according to the Census Bureau’s American Community Survey.  (Since January 2015, five other states have expanded Medicaid.) 

While uninsured rates fell in both expansion and non-expansion states in 2015, they fell more in expansion states.  As a result, the gap between these two groups of states grew from 4.1 percentage points in 2013 to 4.8 percentage points in 2014 and 5.1 percentage points in 2015 (see chart).

Health reform’s Medicaid expansion enables states, if they choose, to cover all non-elderly adults with incomes up to 138 percent of the poverty line — including, for the first time, low-income adults without children.  The federal government picks up all expansion costs through 2016 and at least 90 percent of the cost thereafter.  In addition to health coverage gains, many expansion states have seen budget savings as well as improvements in residents’ health and financial well-being.