What happened in states that expanded Medicaid and ones that didn’t?

As of the end of June 2014, Gallup found the highest coverage since they started measuring in 2008.

But take a look at the breakdown between states that expanded Medicaid and ones that did not, courtesy of a study from the Urban Institute.

The pattern is very clear, but here is a numerical summary:

The uninsurance rate for nonelderly adults dropped 6.1 percentage points (95% CI [4.9, 7.2]) in the expansion states, compared with 1.7 percentage points (95% CI [0.3, 3.0]) in the nonexpansion states. This represents a decline in the uninsurance rate of 37.7 percent in the expansion states and only 9.0 percent in the nonexpansion states.

Maine, of course, did not expand Medicaid because it was blocked by Gov. LePage, a move supported by most Republicans.

Now Maine hospitals, which supported expansion, have more hospital debt.

In Lewiston, St. Mary’s Regional Medical Center budgeted for 5 percent of patients to be uninsured this year. Instead, so far, 8 percent are, and the hospital is about $2.3 million over budget on charity care and bad debt — money patients owe and can’t pay.

It’s on track to be $5.6 million over budget by year’s end. [source]

Money aside, there’s been a huge impact on many Mainers, including the mentally ill.

When Maine made deep cuts to its Medicaid program last January, 25,000 parents and childless adults lost their health care coverage. More than six months later, staffers at the Maine chapter of the National Alliance on Mental Illness say they are overwhelmed by calls.

The calls are from clients with little or no financial resources who are struggling to find treatment.  The changes in eligibility are also taxing the resources of Maine’s jails and hospital emergency rooms that have become the refuge of last resort for hundreds of Medicaid castoffs. [source]

Medicaid expansion was one of the pillars of the Affordable Care Act, sure and strong before the Supreme Court ruled states could decide not to expand.

States that took the expansion path covered many, many of their citizens, while non-expansion states ended up with a far smaller drop in uninsurance.

And the consequences for human beings have been profound.


Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.