Post-Stimulus, States Move Closer to Adopting Medicaid Expansion

Several states that previously held out on approving Medicaid expansion under the Affordable Care Act are now moving toward approval as a result of the American Rescue Plan Act of 2021. As of this article, the following states have not adopted the Medicaid expansion: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, Wyoming.

Before the American Rescue Plan, certain state legislatures rejected governors’ attempts at Medicaid expansion (Alabama, Kansas, Wisconsin), while others proposed bills or budget space but failed to implement the expansion (North Carolina, Wyoming).  Georgia and South Carolina extended coverage with work requirement conditions, but did not expand Medicaid – and the American Rescue Plan has also revised how persons approved for or collecting unemployment benefits are eligible for PTC.

The American Rescue Plan increases the federal contribution to Medicaid expansion costs from 90% to 95%. Specifically, the law increases the federal match by 5% for non-expansion populations in any state that newly expands Medicaid, on top of the 90% match for expansion populations.  It is estimated that non-expansion populations make up almost 80% of state Medicaid spending, so this 5% increase is a significant monetary incentive for these states.

Read more here about Medicaid Expansion here:  https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/