The Affordable Care Act granted states the option to broaden the eligibility criteria for Medicaid.
The expansion allowed a range this programs is designed to assist individuals with low income who earn up to 138% of the federal poverty level.
While the federal government agreed to cover 90% of the program’s costs, states were responsible for the remaining 10%.
According to the Kaiser Family Foundation, this move led to a substantial increase in Medicaid enrollment, with 93.8 million individuals enrolled in Medicaid and the Children’s Health Insurance Program as of May 2023.
However, not all states embraced Medicaid expansion.
While 40 states and Washington DC adopted it, ten still need to, and they face unique healthcare challenges. Here’s a closer look at these ten states:
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Medicaid Enrollment and Health Challenges Across States
Alabama
- Medicaid and CHIP enrollment, May 2023: 1.2 million
- 43.4% increase in enrollment since before the Affordable Care Act
Alabama faces health challenges, ranking 42nd in overall health system performance. Heart disease is a significant concern, with the state having the nation’s third-highest heart disease death rate.
Florida
- Medicaid and CHIP enrollment, May 2023: 4.8 million
- 13.0% increase in enrollment since before the Affordable Care Act
Florida experienced a reduced Medicaid enrollment when pandemic-related protections ended in early 2023. This may lead to further losses in health coverage.
Georgia
- Medicaid and CHIP enrollment, May 2023: 2.5 million
- 50.8% increase in enrollment since before the Affordable Care Act
Georgia recently launched Georgia Pathways to Coverage, expanding Medicaid with work requirements.
However, this program does not qualify for federal funding, resulting in higher costs for the state.
Kansas
- Medicaid and CHIP enrollment, May 2023: 472,492
- 23.1% increase in enrollment since before the Affordable Care Act
Kansas faces mental health challenges, ranking last in the country for prevalence of mental illness and access to care.
Expanding Medicaid could provide affordable mental health and substance abuse treatment.
Mississippi
- Medicaid and CHIP enrollment, May 2023: 791,409
- 30.7% increase in enrollment since before the Affordable Care Act
Mississippi ranks last in health system performance and faces challenges in preterm birth rates, breast and cervical cancer deaths, and premature deaths from treatable and preventable causes.
South Carolina
- Medicaid and CHIP enrollment, May 2023: 1.3 million
- 34.2% increase in enrollment since before the Affordable Care Act
South Carolina struggles with chronic diseases, with 6 in 10 adults having at least one chronic condition. Initiatives like Healthy Me—Healthy SC aim to address these challenges.
Tennessee
- Medicaid and CHIP enrollment, May 2023: 1.8 million
- 34.1% increase in enrollment since before the Affordable Care Act
Tennessee ranks 46th in health care, with high rates of avoidable emergency room visits and premature deaths.
Expanding Medicaid could provide affordable access to care.
Texas
- Medicaid and CHIP enrollment, May 2023: 6.0 million
- 25.0% increase in enrollment since before the Affordable Care Act
Texas has one of the highest uninsured rates in the nation, and recent reductions in Medicaid coverage could exacerbate the issue.
Wisconsin
- Medicaid and CHIP enrollment, May 2023: 1.5 million
- 43.4% increase in enrollment since before the Affordable Care Act
Wisconsin has not adopted Medicaid expansion despite public support.
The state faces challenges in public health funding and chronic diseases.
Wyoming
- Medicaid and CHIP enrollment, May 2023: 84,685
- 25.6% increase in enrollment since before the Affordable Care Act
Medicaid expansion in Wyoming remains elusive despite population support.
The state’s aging population faces challenges in chronic diseases.
While Medicaid expansion remains a contentious issue in these states, addressing each region’s unique health care challenges is crucial to improving the overall well-being of residents.
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Source: Albuquerque Journal
