The Impact of Not Participating in the Affordable Care Act's Medicaid Expansion

March 2014 -- Hover over legend to see expansion status and over non-participating states to see the impact of not expanding Medicaid eligibility. The loss of funds takes into account tax revenues in each state that support the Medicaid expansion and the net loss of federal funds in 2022 in states that choose not to participate, assuming all other states expand.

Medicaid Expansion by State

Interact with the map below to see the impact of not participating in the Medicaid expansion


*Adults in Wisconsin are eligible for Medicaid up to 100% of federal poverty.
Note: CMS has approved waivers for expansion with variation in Arkansas, Iowa, and Michigan. Pennsylvania’s waiver is currently under review by CMS. 
Source for map: Avalere State Reform Insights; Center of Budget and Policy Priorities; Politico.com; Commonwealth Fund analysis
Source for coverage gap and federal funds data: Kaiser Family Foundation, State Health Facts; S. Glied and S. Ma, How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion, The Commonwealth Fund, December 2013.