Analysis: Millions more would be insured if Supreme Court upheld Medicaid expansion

An extra 3 million people would have gained health insurance if the Supreme Court had ruled in favor of the Obama administration's Medicaid plans two years ago, according to new data.

If all states had expanded their eligibility for the low-income insurance program, the percent of people without insurance nationwide would have fallen by two percentage points, according to a model created by the nonprofit group Enroll America and a data analytics group called Civis. The data was analyzed and published by the New York Times on Monday.

A majority of the uninsured people who would have benefitted from an expansion of Medicaid – the government’s low-income insurance program – live in Southern states stretching from Virginia to Texas.


Twenty-one states have declined to expand eligibility under Medicaid, a move that would have brought a windfall of federal dollars into the state but would also put the state on the hook for later costs.

Many of those states already had the lowest rates of insurance and the highest rates of poverty. In Mississippi and Louisiana, for example, more than 15 percent of adults between 18 and 65 remain uninsured in 2014, according to the data.

The Affordable Care Act initially required all states to comply with the Medicaid expansion. But a Supreme Court ruling in the summer of 2012 made the expansion voluntary, morphing the policy into a heated political battle to oppose federal overreach.

Over the last two years, a majority of Republican governors and legislatures have declined the expansion, leaving large pockets of uninsured throughout the Deep South, as well as poor, rural parts of Idaho, Wyoming and Maine.

The number of people without health insurance dropped dramatically since ObamaCare went into effect, with the rate among non-elderly adults falling by 26 percentage points, according to a report by the Department of Health and Human Services on Monday. A total of 10.3 million people between the ages of 18 and 64 gained insurance since last October’s open enrollment, the report said.

Medicaid could see a boom in enrollment as a result of the 2014 elections, with insurance at stake for an extra 1.7 million people. Democrats running in five highly competitive governors races this year — Florida, Maine, Kansas, Wisconsin and Georgia — have all vowed to expand Medicaid coverage through ObamaCare if they are elected.