Spending on Medicaid expansion enrollees by state
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The Affordable Care Act provides for states to expand eligibility for their Medicaid programs to cover childless adults whose income amounted to 138 percent of the federal poverty level (FPL) or below. The federal government paid 100 percent of the costs for these enrollees for the first few years of the expansion. The law incrementally reduces the federal share of the cost of these individuals to reach 90 percent in 2020 and remain there thereafter.
On January 1, 2017, states began contributing 5 percent of the total cost of covering expansion enrollees; this amount increased to 6 percent in 2018. Some states that covered childless adults through Medicaid before the Affordable Care Act were already contributing some state funds to their coverage before January 1, 2017. For individuals who had been eligible for Medicaid prior to the expansion but chose to enroll afterward, the federal share of their costs remains at pre-ACA levels.[1]
In its spring 2017 report, the National Association of State Budget Officers collected data from states on spending for individuals enrolled in Medicaid under the expanded eligibility provisions of the ACA. The organization found that about $78 billion was spent nationwide on Medicaid expansion enrollees during 2016, with 95.1 percent of this spending being funded by the federal government. The table below provides these figures as broken down into state funds and federal funds for all 50 states, as well as the nation as a whole. Information was collected only from states that had expanded Medicaid; states that did not expand Medicaid are marked with N/A.[1]
| Medicaid expansion spending by state, 2016 | ||||||
|---|---|---|---|---|---|---|
| State | Dollars | Percent | ||||
| State | Federal | Total | State | Federal | ||
| Alabama | N/A | N/A | N/A | N/A | N/A | |
| Alaska | $0 | 139,000,000 | 139,000,000 | 0.0% | 100.0% | |
| Arizona | $208,000,000 | $2,299,000,000 | $2,506,000,000 | 8.3% | 91.7% | |
| Arkansas | $0 | $1,554,000,000 | $1,554,000,000 | 0.0% | 100.0% | |
| California | $369,000,000 | $19,892,000,000 | $20,261,000,000 | 1.8% | 98.2% | |
| Colorado | $5,000,000 | $1,722,000,000 | $1,727,000,000 | 0.3% | 99.7% | |
| Connecticut | $59,000,000 | $1,300,000,000 | $1,359,000,000 | 4.3% | 95.7% | |
| Delaware | $54,000,000 | $371,000,000 | $425,000,000 | 12.7% | 87.3% | |
| Florida | N/A | N/A | N/A | N/A | N/A | |
| Georgia | N/A | N/A | N/A | N/A | N/A | |
| Hawaii | $24,000,000 | $582,000,000 | $606,000,000 | 4.0% | 96.0% | |
| Idaho | N/A | N/A | N/A | N/A | N/A | |
| Illinois | $140,000,000 | $3,360,000,000 | $3,500,000,000 | 4.0% | 96.0% | |
| Indiana | $271,000,000 | $1,761,000,000 | $2,032,000,000 | 13.3% | 86.7% | |
| Iowa | $25,000,000 | $937,000,000 | $962,000,000 | 2.6% | 97.4% | |
| Kansas | N/A | N/A | N/A | N/A | N/A | |
| Kentucky | $0 | $3,139,000,000 | $3,139,000,000 | 0.0% | 100.0% | |
| Louisiana | N/A | N/A | N/A | N/A | N/A | |
| Maine | N/A | N/A | N/A | N/A | N/A | |
| Maryland | $3,000,000 | $2,353,000,000 | $2,356,000,000 | 0.1% | 99.9% | |
| Massachusetts | $471,000,000 | $1,627,000,000 | $2,098,000,000 | 22.4% | 77.6% | |
| Michigan | $48,000,000 | $3,645,000,000 | $3,694,000,000 | 1.3% | 98.7% | |
| Minnesota | $2,000,000 | $1,657,000,000 | $1,659,000,000 | 0.1% | 99.9% | |
| Mississippi | N/A | N/A | N/A | N/A | N/A | |
| Missouri | N/A | N/A | N/A | N/A | N/A | |
| Montana | $1,000,000 | $106,000,000 | $107,000,000 | 0.9% | 99.1% | |
| Nebraska | N/A | N/A | N/A | N/A | N/A | |
| Nevada | $0 | $1,062,000,000 | $1,062,000,000 | 0.0% | 100.0% | |
| New Hampshire | $0 | $406,000,000 | $406,000,000 | 0.0% | 100.0% | |
| New Jersey | $39,000,000 | $2,872,000,000 | $2,910,000,000 | 1.3% | 98.7% | |
| New Mexico | $0 | $1,139,000,000 | $1,139,000,000 | 0.0% | 100.0% | |
| New York | $2,612,000,000 | $7,639,000,000 | $10,250,000,000 | 25.5% | 74.5% | |
| North Carolina | N/A | N/A | N/A | N/A | N/A | |
| North Dakota | $7,000,000 | $302,000,000 | $309,000,000 | 2.3% | 97.7% | |
| Ohio | $0 | $4,395,000,000 | $4,395,000,000 | 0.0% | 100.0% | |
| Oklahoma | N/A | N/A | N/A | N/A | N/A | |
| Oregon | $0 | $2,643,000,000 | $2,643,000,000 | 0.0% | 100.0% | |
| Pennsylvania | $117,000,000 | $3,794,000,000 | $3,911,000,000 | 3.0% | 97.0% | |
| Rhode Island | $0 | $380,000,000 | $380,000,000 | 0.0% | 100.0% | |
| South Carolina | N/A | N/A | N/A | N/A | N/A | |
| South Dakota | N/A | N/A | N/A | N/A | N/A | |
| Tennessee | N/A | N/A | N/A | N/A | N/A | |
| Texas | N/A | N/A | N/A | N/A | N/A | |
| Utah | N/A | N/A | N/A | N/A | N/A | |
| Vermont | $49,000,000 | $223,000,000 | $272,000,000 | 18.0% | 82.0% | |
| Virginia | N/A | N/A | N/A | N/A | N/A | |
| Washington | $15,000,000 | $2,074,000,000 | $2,089,000,000 | 0.7% | 99.3% | |
| West Virginia | $3,000,000 | $770,000,000 | $773,000,000 | 0.4% | 99.6% | |
| Wisconsin | N/A | N/A | N/A | N/A | N/A | |
| Wyoming | N/A | N/A | N/A | N/A | N/A | |
| United States | $4,522,000,000 | $74,144,000,000 | $78,000,000,000 | 5.8% | 95.1% | |
| Source: National Association of State Budget Officers, "The Fiscal Survey of the States: Spring 2017" | ||||||
Effect of the Affordable Care Act in the 50 states
Click on a state below to read more about the effect of the Affordable Care Act in that state.
See also
Footnotes
