An additional 4.4 million people would gain insurance coverage if the ACA’s Medicaid expansion were implemented nationwide, according to a new report.
All told, that accounts for 36% of the current uninsured, nonelderly population in the U.S., according to a Kaiser Family Foundation brief.
In some states, more than half of people in that population would be eligible for Medicaid under expansion. For example, 54% of Alabama's population, or about 223,000 people, would qualify for coverage. In Mississippi, about 53% of the population, or 123,000 uninsured, nonelderly adults, would be covered.
The greatest number of people who would be newly insured are in Texas, however, where 1.4 million residents would gain coverage, or about 36% of the uninsured, nonelderly people in the state. Florida also has many people who would gain coverage under expansion—about 837,000.
These two states together make up just over half (51%) of the total population that would be newly eligible, according to the study.
Of the more than 4 million people who would become eligible, 75% are childless adults, including 2.2 million women, the data show. Childless adults have traditionally been unable to qualify for Medicaid, and the growth in their enrollment has triggered a backlash.
Wisconsin, for instance, is the only state that implemented Medicaid expansion but barred childless adults from eligibility, while other states have called for work requirements in the program to ensure these beneficiaries are employed, KFF said.
Three-quarters of the 4.4 million people who would be newly eligible if expansion was implemented across the country are in a family with at least one worker. Fifty-nine percent are in families with at least one full-time worker, and 17% are in families with at least one part-time worker.
In addition, the study found that a significant portion of this population, about 56%, earns less than the federal poverty line, and 60% are people of color. Nearly a third (28%) are Hispanic, and 23% are black, according to the study.
In Texas, for example, 57% of those who would be eligible for Medicaid under expansion are Hispanic. In Mississippi, 52% are black.
Also of note, many people in this group are middle-aged or nearly qualify for Medicare, according to the study. Thirty-five percent of the newly eligible are between the ages of 35 and 54, with an additional 16% between ages 55 and 64.
That latter group, according to the study, is especially notable, as they may have chronic conditions that require costly maintenance.