Medicaid Expansion : What’s the Status in Your State?
To date, 10 states have resisted the Affordable Care Act’s coverage expansion.
With the end of the requirement for continuous Medicaid coverage, up to 15 million Americans could lose their benefits over the next 12 months.
That loss will be felt most in the 10 states that have not expanded Medicaid eligibility as allowed by the Affordable Care Act. Those states already have higher uninsured rates and more hospital closings, the Commonwealth Fund report said.

Residents will now be at greater risk of losing their Medicaid coverage and not having available alternatives.

Many fall into the coverage gap, which is too much to qualify for Medicaid but not enough to qualify for ACA marketplace subsidies.
The Urban Institute estimated that if all holdout states adopted Medicaid expansion, 3.7 million fewer Americans would be uninsured.
For more information, find out when Medicare open enrollment ends and learn about Medicare price changes for 2023.
What is Medicaid expansion?
The Affordable Care Act expanded Medicaid coverage to nearly all adults with incomes up to 138% of the federal poverty level. (In 2023, this equates to $20,120 for an individual or $41,400 for a family of four.)
It also increased federal matching funds for states that expanded their coverage.
The expansion was originally a requirement, but a June 2012 Supreme Court ruling essentially made it optional for states.
To encourage adoption, the US Rescue Act of 2021 provides new expansion states with a 5% increase in matching federal funds for two years.
Which states have expanded Medicaid coverage?
As of March 30, 2023, 40 states and Washington, DC had adopted the Medicaid expansion.
South Dakota voters approved the Medicaid expansion last November, but it won’t go into effect until July 1.
The North Carolina Legislature approved the expansion in March 2023, which will begin in early 2024.
Which States Didn’t Expand Medicaid?
Ten states — Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming — have not adopted Medicaid expansion.
In his State of the State address in January, Mississippi Gov. Tate Reeves urged lawmakers to reject expanding the program.
“Don’t simply fall for the pressure from Democrats and their allies in the media to push for the expansion of Obamacare, welfare and socialized medicine,” Reeves said. “Instead, look for innovative, free-market solutions that disrupt traditional health care delivery models, increase competition, and lead to better health outcomes for Mississippians.”
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health care provider with any questions regarding health conditions or health goals.

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