Study: Urban uninsured would drop 60 percent with Medicaid expansion

A new study projects that large cities could see the number of uninsured drop almost 60 percent under ObamaCare’s Medicaid expansion.

The report by the Robert Wood Johnson Foundation and the Urban Institute looked at numbers for 14 major cities and estimated the percentage of uninsured would drop by an average of 57 percent in 2016 if states that have adopted the Medicaid expansion.


Those cities studied in the report are Chicago, Columbus, Denver, Detroit, Los Angeles, Phoenix and Seattle.

By comparison, cities in states that have not adopted the provision are still likely to see a drop in the uninsured, but only by an average of 30 percent.

Those cities include Atlanta, Charlotte, Houston, Indianapolis, Memphis, Miami and Philadelphia.

“Medicaid expansion helped those who needed it the most, low and moderate income people,” noted John Lumpkin, senior vice president at the Robert Wood Johnson Foundation.

The drop in uninsured in cities where Medicaid has been expanded is expected to range from 49 percent in Denver and 66 percent in Detroit.

The federal cost of covering more people would also range from $4.1 billion in Seattle to $27 billion in Los Angeles by 2023.

The report says if Medicaid was expanded to the non-participating cities in their analysis, the drop in uninsured would average 52 percent.

However, that would also mean federal spending would increase between $4.8 billion in Atlanta and $16.4 billion in Houston from 2014 to 2023.

The study’s authors say cities that don’t expand Medicaid are likely to face more economic hardship.

“Cities in states not expanding Medicaid would face other challenges in addition to having more uninsured residents and foregoing additional revenue,” they said.

“There will be reductions in Medicare reimbursement and Medicare and Medicaid disproportionate share hospital payments under the ACA, which could be particularly difficult for urban safety-net providers serving uninsured people across a wider region.”

A number of Republican governors have rejected the Medicaid expansion, arguing that while the federal government will provide funds initially, the long term burden of the program will drain state budgets.