New Urban Paper Compares Eligibility for Assistance Across States

By Martha Heberlein

Some exciting new state-by-state data from the Urban Institute gives states a better sense of how many people might be eligible for and enroll in the expanded coverage options under the ACA, finding that more than 25 million uninsured are eligible for some sort of assistance securing coverage.

As expected, there’s large variation in the numbers when comparing states that are expanding Medicaid and those that are not – almost seven in 10 uninsured people who live in a state that is expanding Medicaid are eligible for assistance, compared to fewer than 4 in 10 uninsured people who live in states that are not moving forward.

In those states expanding coverage, about 10.4 million people would be eligible for Medicaid or CHIP and 4.7 million would be eligible for premium tax credits in the marketplaces. In stark contrast, in states not expanding Medicaid, just 2.7 million people would be eligible for Medicaid or CHIP and 7.5 million would be eligible for subsidized private coverage. As a result, the ACA is expected to decrease the number uninsured by between 28-38% in the states not choosing to extend Medicaid to more poor adults.

The last table provides the share of the uninsured eligible for assistance and the projected reduction in the uninsured in every state with and without the Medicaid expansion – data that are especially helpful for those states where the expansion is still up for debate (or should be).

Take Ohio, for example, where the state is still considering its options. If it adopts the expansion, 81% of its uninsured population will be eligible for assistance securing coverage and it could see a 55% reduction in the uninsured. Without the expansion, just 42% of its uninsured population will be eligible and the uninsured will be reduced by just 33%.

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