The 20 states choosing not to expand their Medicaid programs under the Affordable Care Act are forgoing billions of dollars in federal funds, even while their residents are contributing to the cost of the expansions in other states, a new Commonwealth Fund study finds.
The states with the highest net losses, after taking into account federal taxes paid by state residents, include Texas, Florida, Georgia, and Virginia. The analysis, conducted by Sherry Glied and Stephanie Ma of New York University's Wagner Graduate School of Public Service, is the first to calculate the net cost to taxpayers of states' decisions to turn down the Affordable Care Act's Medicaid expansion, which became voluntary after the Supreme Court’s 2012 ruling.
The federal government pays 100 percent of the expansion's total costs through 2016. By 2020, the federal contribution declines to 90 percent.
Visit commonwealthfund.org for the complete analysis and our infographic showing which states stand to gain and lose the most.