Cities In States That Expand Medicaid Will See A Huge Drop In Their Uninsured Residents


Large cities in states that have adopted Obamacare’s Medicaid expansion will see numbers of uninsured people drop by nearly 60 percent by 2016, according to new projections.

The predictions, compiled in a report by the Robert Wood Johnson Foundation and the Urban Institute, come from data out of 14 major cities. Half of those cities are located in states that accepted federal funding and agreed to expand their Medicaid programs; the other half are located in states that did not.

For cities in the states that have agreed to the Medicaid expansion, which extends eligibility to people making up to 138 percent of the federal poverty level, the percentage of uninsured people will drop by an average of 57 percent in the next two years. For cities in the states that have rejected the increased federal funding, the uninsured rate will decrease by an average of only 30 percent, due to the other provisions in the Affordable Care Act:



Under the expansion, more than half of the total population in Detroit, Miami, Memphis, and Philadelphia would be eligible for Medicaid or income-based subsidized coverage. But Detroit is the only one of them that’s in a state opting to expand Medicaid.

If all the cities in the study expanded Medicaid eligibility, the number of uninsured would fall by 52 percent, according to the report. The highest decrease in uninsured would be Memphis, with a nearly 60 percent decrease. Houston would receive the largest increase in federal spending — they’d get $16.4 billion between 2014 and 2023.

In states choosing to expand Medicaid, the report concludes that “substantial revenue will flow into these cities and the economies of these cities should benefit greatly.”

Though states that have expanded Medicaid are already seeing positive results, 24 states have opted out of the Medicaid expansion. A report from earlier this year showed that many of the states that are rejecting the Medicaid expansion are states whose populations need it the most. Opting out also costs these states millions in federal funds.

Abigail Bessler is an intern at ThinkProgress.