Study: States Rejecting Medicaid Expansion Losing Billions

WASHINGTON — The 20 states choosing not to expand Medicaid will lose billions of dollars in federal funds, according to a new study released Thursday.

By 2022, Texas could lose $9.2 billion by not expanding Medicaid as allowed under the Affordable Care Act, while Florida could lose $5 billion over that period, the study conducted by The Commonwealth Fund shows. Commonwealth was founded in 1918 to improve health services for Americans.

Also during that period, the study showed, Georgia could lose $2.9 billion, while Virginia could lose $2.8 billion.

"There are no states where the taxpayers would actually gain by not expanding Medicaid," said Sherry Glied, lead author on the study. "Nobody wins."

Under the Affordable Care Act, states may expand their Medicaid programs to include anyone who falls beneath 138% of the federal poverty level, or about $32,500 for a family of four. But the 2012 Supreme Court decision that upheld the law also said states could choose not to expand Medicaid and not lose federal funding for their existing programs.

All 20 of the states choosing not to expand Medicaid have Republican governors. Many have said increasing Medicaid could add to the federal deficit. Others have long opposed the law since its passage in 2010.

Medicaid, however, is a federal program, Glied said, and residents of states that have not expanded the program are still paying taxes to support it. They're just not getting the extra benefits in their states.

"When you hear the states talk about it, they talk about raising state taxes for it," she said. "But that's not the case."

The extra federal money spent on Medicaid goes directly to local health care providers, such as hospitals or physicians, and helps the overall state economy, Glied said.

"There's new money flowing into the states," she said. "It's sort of like why states are eager to get defense contracts: It can be used to create jobs."

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