The expansion of Medicaid under healthcare reform will significantly increase the number of people covered by the program, with the federal government picking up the overwhelming majority of the cost, according to a study by the Kaiser Family Foundation.
The analysis, performed by John Holahan and Irene Headen of the Urban Institute, is among the first to show for all 50 states and the District of Columbia the distribution of new Medicaid enrollees and costs, as well as the impact on the uninsured.
Healthcare reform legislation will offer Medicaid coverage to millions of low-income adults for the first time and help establish a national floor for Medicaid eligibility that contrasts with the wide variation in eligibility across state Medicaid programs.
States with large uninsured populations are expected to see the biggest increases in the numbers of people who obtain health coverage through Medicaid.
According to the study, California and Texas – two states with considerable numbers of uninsured residents – are each projected to see 1.4 million fewer uninsured adults in 2019 due to Medicaid expansion, with the federal government covering 95 percent of the cost in Texas and 94 percent in California.
"For a relatively small investment of state dollars, states could see huge returns in terms of additional coverage for their lowest income residents – with federal dollars covering the bulk of the bill," said Diane Rowland, executive vice president of the foundation.
Nationally, the analysis projects that Medicaid enrollment will climb by 15.9 million more people by 2019 than it otherwise would have, and the number of uninsured will fall by more than 11 million.
The cost of Medicaid expansion between 2014 and 2019 would be jointly financed with the federal government paying $443.5 billion (or 95.4 percent of the total cost) and the states contributing $21.2 billion.