Effect of the Affordable Care Act on Medicaid spending by state
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In November 2012, the Henry J. Kaiser Family Foundation (KFF) released a report analyzing the difference in Medicaid expenditures if each state were to expand eligibility for the program as allowed under the Affordable Care Act. The organization found that nationwide, total Medicaid expenditures would be $1.02 trillion higher (an increase of 16.2 percent) between 2013 and 2022 if all states implemented Medicaid expansion than if there was no Medicaid expansion. Total state costs would be $76.5 billion higher, while federal costs would be $952.5 billion higher. Even without expanding Medicaid, the requirement that states make it easier to enroll in the program and the individual mandate could encourage some new individuals to sign up, even if they had already been eligible. States could incur additional costs from the program if this happened.[1][2]
As of April 2017, 32 states had expanded Medicaid. The Kaiser report showed that Georgia would see the greatest increase in total Medicaid expenditures, 32.7 percent, if it expanded the program. Vermont was projected to see the smallest increase at 3.3 percent. See the table below for further details. To read the full report, click here.
| Total Medicaid expenditures under the ACA with all states expanding Medicaid compared to no ACA, 2013 - 2022 | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| State | Expenditures without ACA (in millions) | Expenditures under ACA - all states expanding (in millions) | Change relative to no ACA | ||||||
| Federal | State | Total | Federal | State | Total | Federal | State | Total | |
| Alabama | $52,137 | $22,791 | $74,929 | $67,521 | $24,071 | $91,592 | 29.5% | 5.6% | 22.2% |
| Alaska | $11,599 | $9,557 | $21,156 | $13,236 | $9,883 | $23,118 | 14.1% | 3.4% | 9.3% |
| Arizona | $73,273 | $34,711 | $107,984 | $90,554 | $37,848 | $128,401 | 23.6% | 9.0% | 18.9% |
| Arkansas | $42,494 | $16,825 | $59,319 | $55,681 | $18,046 | $73,726 | 31.0% | 7.3% | 24.3% |
| California | $379,409 | $366,840 | $746,250 | $464,016 | $380,810 | $844,826 | 22.3% | 3.8% | 13.2% |
| Colorado | $31,518 | $29,657 | $61,175 | $43,086 | $31,154 | $74,239 | 36.7% | 5.0% | 21.4% |
| Connecticut | $45,962 | $43,419 | $89,381 | $55,954 | $43,068 | $99,022 | 21.7% | -0.8% | 10.8% |
| Delaware | $12,503 | $9,433 | $21,937 | $15,228 | $8,929 | $24,157 | 21.8% | -5.4% | 10.1% |
| District of Columbia | $19,846 | $7,893 | $27,739 | $20,836 | $8,019 | $28,854 | 5.0% | 1.6% | 4.0% |
| Florida | $146,971 | $111,964 | $258,935 | $220,266 | $120,849 | $341,114 | 49.9% | 7.9% | 31.7% |
| Georgia | $84,211 | $41,374 | $125,585 | $122,153 | $44,512 | $166,665 | 45.1% | 7.6% | 32.7% |
| Hawaii | $12,142 | $10,626 | $22,768 | $15,917 | $10,758 | $26,675 | 31.1% | 1.2% | 17.2% |
| Idaho | $17,218 | $6,640 | $23,858 | $20,967 | $6,901 | $27,868 | 21.8% | 3.9% | 16.8% |
| Illinois | $127,178 | $122,847 | $250,024 | $156,621 | $129,279 | $285,900 | 23.2% | 5.2% | 14.3% |
| Indiana | $69,777 | $33,130 | $102,907 | $88,698 | $34,515 | $123,212 | 27.1% | 4.2% | 19.7% |
| Iowa | $34,293 | $20,657 | $54,950 | $39,722 | $20,335 | $60,058 | 15.8% | -1.6% | 9.3% |
| Kansas | $27,886 | $19,691 | $47,577 | $34,582 | $20,734 | $55,316 | 24.0% | 5.3% | 16.3% |
| Kentucky | $63,441 | $24,831 | $88,271 | $82,173 | $26,404 | $108,577 | 29.5% | 6.3% | 23.0% |
| Louisiana | $62,963 | $38,737 | $101,700 | $79,708 | $40,515 | $120,223 | 26.6% | 4.6% | 18.2% |
| Maine | $26,920 | $14,682 | $41,602 | $30,432 | $14,246 | $44,677 | 13.0% | -3.0% | 7.4% |
| Maryland | $55,564 | $53,690 | $109,254 | $69,064 | $53,187 | $122,250 | 24.3% | -0.9% | 11.9% |
| Massachusetts | $100,045 | $96,223 | $196,268 | $111,599 | $92,209 | $203,808 | 11.5% | -4.2% | 3.8% |
| Michigan | $105,103 | $51,557 | $156,661 | $130,659 | $55,583 | $186,242 | 24.3% | 7.8% | 18.9% |
| Minnesota | $73,933 | $71,324 | $144,957 | $80,688 | $73,255 | $153,943 | 9.6% | 2.7% | 6.2% |
| Mississippi | $47,520 | $15,749 | $63,269 | $63,188 | $16,949 | $80,138 | 33.0% | 7.6% | 26.7% |
| Missouri | $75,647 | $42,108 | $117,754 | $96,610 | $44,906 | $141,515 | 27.7% | 6.6% | 20.2% |
| Montana | $10,555 | $4,694 | $15,249 | $13,370 | $5,130 | $18,500 | 26.7% | 9.3% | 21.3% |
| Nebraska | $19,750 | $14,005 | $33,755 | $23,162 | $14,522 | $37,685 | 17.3% | 3.7% | 11.6% |
| Nevada | $16,904 | $10,548 | $25,453 | $21,525 | $11,745 | $33,270 | 44.4% | 11.3% | 30.7% |
| New Hampshire | $13,078 | $11,657 | $24,735 | $15,736 | $11,927 | $27,709 | 20.3% | 2.7% | 12.0% |
| New Jersey | $87,540 | $83,923 | $171,463 | $107,339 | $87,299 | $194,637 | 22.6% | 4.0% | 13.5% |
| New Mexico | $38,064 | $16,081 | $54,144 | $43,758 | $16,688 | $60,446 | 15.0% | 3.8% | 11.6% |
| New York | $468,498 | $450,977 | $919,475 | $552,996 | $433,308 | $986,300 | 18.0% | -3.9% | 7.3% |
| North Carolina | $127,286 | $65,988 | $193,273 | $171,996 | $71,086 | $243,082 | 35.1% | 7.7% | 25.8% |
| North Dakota | $7,748 | $5,142 | $12,890 | $10,642 | $5,598 | $16,241 | 37.4% | 8.9% | 26.0% |
| Ohio | $165,732 | $90,473 | $256,205 | $223,742 | $97,100 | $320,842 | 35.0% | 7.3% | 25.2% |
| Oklahoma | $44,197 | $23,989 | $68,186 | $53,344 | $25,010 | $78,354 | 20.7% | 4.3% | 14.9% |
| Oregon | $38,320 | $21,284 | $59,604 | $53,027 | $22,087 | $75,113 | 38.4% | 3.8% | 26.0% |
| Pennsylvania | $167,518 | $132,284 | $299,802 | $210,859 | $136,278 | $347,138 | 25.9% | 3.0% | 15.8% |
| Rhode Island | $19,375 | $16,507 | $35,882 | $22,527 | $16,957 | $39,484 | 16.3% | 2.7% | 10.0% |
| South Carolina | $53,227 | $21,715 | $74,942 | $70,230 | $23,242 | $93,472 | 31.9% | 7.0% | 24.7% |
| South Dakota | $9,148 | $5,416 | $14,563 | $11,370 | $5,608 | $16,978 | 24.3% | 3.6% | 16.6% |
| Tennessee | $95,404 | $46,824 | $142,228 | $120,650 | $49,130 | $169,780 | 26.5% | 4.9% | 19.4% |
| Texas | $227,935 | $158,947 | $386,882 | $305,266 | $168,582 | $473,848 | 33.9% | 6.1% | 22.5% |
| Utah | $21,989 | $8,295 | $30,284 | $28,996 | $9,002 | $37,998 | 31.9% | 8.5% | 25.5% |
| Vermont | $12,035 | $7,880 | $19,946 | $13,359 | $7,214 | $20,573 | 11.0% | -8.5% | 3.3% |
| Virginia | $52,220 | $50,066 | $102,286 | $68,633 | $52,682 | $121,316 | 31.4% | 5.2% | 18.6% |
| Washington | $94,060 | $58,786 | $119,846 | $71,226 | $60,206 | $131,432 | 16.6% | 2.4% | 9.7% |
| West Virginia | $33,667 | $11,955 | $45,622 | $42,798 | $12,531 | $55,329 | 27.1% | 4.8% | 21.3% |
| Wisconsin | $64,302 | $40,471 | $104,773 | $78,057 | $41,196 | $119,253 | 21.4% | 1.8% | 13.8% |
| Wyoming | $6,205 | $4,927 | $11,132 | $7,705 | $5,131 | $12,836 | 24.2% | 4.1% | 15.3% |
| United States | $3,659,010 | $2,679,790 | $6,338,799 | $4,611,463 | $2,756,269 | $7,367,732 | 26.0% | 2.9% | 16.2% |
| Source: The Henry J. Kaiser Family Foundation, "The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis" | |||||||||
Medicaid spending in the 50 states
Click on a state below to read more about Medicaid spending in that state.
See also
Footnotes
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedcbpp - ↑ The Henry J. Kaiser Family Foundation, "The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis," November 2012
