Now that New Jersey Governor Chris Christie has announced his support for health reform’s Medicaid expansion, becoming the eighth Republican governor to do so, more than half of the states — 25, plus the District of Columbia — are expanding Medicaid in 2014 or making significant progress toward doing so, as our map shows.
States expanding or moving toward expansion will experience large gains in health coverage, starting next year. In these 25 states and Washington, D.C., nearly 8 million low-income people will gain coverage through Medicaid by 2022, according to Urban Institute projections for the Kaiser Commission on Medicaid and the Uninsured. If the remaining 25 states do not adopt the expansion, however, nearly 8 million of the lowest-income residents in those states will be left behind and likely remain uninsured.
More states will likely move toward expansion before their legislative sessions end. While a state can opt into the Medicaid expansion at any time, lawmakers should recognize the benefits of approving the expansion during this legislative session, in time for implementation in 2014. Between 2014 through 2016, the federal government will pay all of the cost of covering those newly eligible for Medicaid (with the federal share of the cost then gradually phasing down to 90 percent for 2020 and every year thereafter). Thus, if a state waits to expand, it won’t be able to take full advantage of the good financial deal that the federal government is offering.