The uninsured population in major cities in states that expanded Medicaid coverage under the Affordable Care Act could fall by as much as 57 percent on average, a report from the Robert Wood Johnson Foundation and Urban Institute finds.
The report, The ACA and America’s Cities: Fewer Uninsured and More Federal Dollars (7 pages, PDF), found that in seven cities in states that expanded Medicaid coverage — Chicago, Columbus, Denver, Detroit, Los Angeles, Phoenix, and Seattle — the ACA is on track to reduce the number of uninsured residents by 49 percent (Denver) to as much as 66 percent (Detroit) by 2016. The report also notes that new federal spending on health care between 2014 and 2023 is likely to range from $4.1 billion in Seattle to $27 billion in Los Angeles.
In contrast, in seven cities without Medicaid expansion — Atlanta, Charlotte, Houston, Indianapolis, Memphis, Miami, and Philadelphia — the number of uninsured is likely to drop 30 percent on average, ranging from 25 percent in Atlanta to 36 percent in Charlotte, while new federal spending is likely to increase some $1.9 billion (Atlanta) to as much as $9.9 billion (Houston). The report estimates that if non-expansion states were to extend Medicaid eligibility to residents with incomes of up to 138 percent of the federal poverty limit, these cities could see a 52 percent reduction in the number of uninsured.
"In states that took advantage of the Affordable Care Act Medicaid expansion, cities saw a dramatic drop in the number of uninsured," said RWJF senior vice president John Lumpkin. "Medicaid expansion helped those who needed it the most, low- and moderate-income people."