How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion? – February 2024

KFF February 26, 2024
Patrick Drake, Jennifer Tolbert, Robin Rudowitz, Anthony Damico

Ten years after the implementation of the Affordable Care Act’s (ACA) coverage options, ten states have not adopted the Medicaid expansion, leaving 1.5 million uninsured people without an affordable coverage option. The unwinding of the Medicaid continuous enrollment provision along with ongoing financial struggles among rural hospitals has focused attention on the gaps in Medicaid coverage in non-expansion states, and availability of temporary enhanced federal funding for states that newly adopt expansion has sparked renewed expansion discussions in some of these states.

Two states (South Dakota and North Carolina) implemented Medicaid expansion in 2023, reducing the number of low-income uninsured people nationally without access to Medicaid. Expansion in those two states brings the count to 40 states and the District...

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