Cities in Medicaid Expansion States To See Big Drop in Uninsured
Uninsured rates in some of the nation's largest and most diverse cities would decline by nearly 60% in 2016 if those cities are in states that expand Medicaid under the Affordable Care Act, according to a joint study released Thursday by the Robert Wood Johnson Foundation and the Urban Institute, the Washington Post's "GovBeat" reports (Chokshi, "GovBeat," Washington Post, 6/19).
For the study, researchers estimated the effects of the Medicaid expansion in 14 large cities, seven in states that have expended Medicaid and seven in states that have not.
In each city, at least 40% of uninsured residents had incomes below 138% of the federal poverty level, which would make them eligible for Medicaid coverage under the expansion (Adams, CQ HealthBeat, 6/19).
The report found that uninsured rates in 2016 would decline by an average of 57% in:
- Columbus, Ohio;
- Los Angeles;
- Phoenix; and
These seven cities are in states that have expanded Medicaid this year.
Meanwhile, the uninsured rates in 2016 would decline by an average of 30% in:
- Charlotte, N.C.;
- Memphis, Tenn.;
- Miami; and
These seven cities are in states that have declined to expand Medicaid.
Among states that have not expanded Medicaid, the projected drop in uninsured rates would vary between 24.8% in Atlanta to 36.4% in Charlotte. Among states that have expanded Medicaid, the projected decline would range between 48.8% in Denver to 65.8% in Seattle ("GovBeat" chart, Washington Post, 6/19).
Researchers also estimated if the cities in non-expansion states expanded their Medicaid program, their uninsured rates would drop by 52% on average, The Hill reports.
According to the study, the Medicaid expansion also would have a significant effect on federal spending in the 14 cities. Federal spending for the cities in Medicaid expansion states is projected to range from $4.1 billion in Seattle to $27 billion in Los Angeles by 2023. Meanwhile, federal spending for the cities in non-expansion states would range from $4.8 billion in Atlanta to $16.4 billion in Houston over the next decade (Al-Faruque, The Hill, 6/19).
Los Angeles-Specific Findings
In Los Angeles, the report found that the number of uninsured residents could drop by 57% because of the expansion of Medi-Cal, California's Medicaid program. In addition, the area is expected to receive about $27 billion more in federal health care funding over the next 10 years, according to the report.
John Lumpkin, senior vice president at the Robert Wood Johnson Foundation, said, "The biggest decline is happening in places like Los Angeles because California lawmakers chose to expand the Medicaid program throughout the state."
Researchers noted that nearly 50% of Los Angeles residents who are likely to remain uninsured are undocumented immigrants who cannot obtain coverage under the ACA (Terhune, Los Angeles Times, 6/19).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.