New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending

KFF February 18, 2021
Robin Rudowitz, Bradley Corallo, Rachel Garfield

As of February 2021, 12 states have not adopted the Affordable Care Act (ACA) provision to expand Medicaid to adults with incomes through 138% of poverty. Millions of people in these states remain without an affordable coverage option. Currently, the federal government covers 90% of the cost of Medicaid coverage for adults covered through the ACA expansion, a higher share than it does for other Medicaid enrollees. The House Energy and Commerce Committee reconciliation proposal as part of the COVID relief package aims to encourage non-expansion states to take up the expansion by providing an additional temporary fiscal incentive for states to newly implement the ACA Medicaid expansion. This brief provides illustrative estimates of the net fiscal benefit to states...

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