If the Remaining States Expand Medicaid, Who Would Benefit? - Families Usa Skip to Main Content

If the Remaining States Expand Medicaid, Who Would Benefit?

By Dee Mahan,


Twenty-two states have chosen not to extend Medicaid coverage, leaving hundreds of thousands of their residents in the health coverage gap. These people—who do not qualify for Medicaid in their state, but cannot afford private insurance or marketplace coverage—are left without any option for affordable health insurance. Who are they?

Using data from several sources, our new infographic shows the populations—uninsured adults, parents with dependent children, working but uninsured adults, and uninsured veterans and their spouses—that could gain health insurance under Medicaid expansion.

By choosing not to extend Medicaid coverage, states are leaving millions behind

Over the past several months, Families USA has been releasing a series of state reports that analyze data about the low-income working Americans in 22 states who stand to benefit if their state expands Medicaid.

But that’s only part of the story. Yes, hard working adults who hold jobs in sectors that are the foundation of many state economies—from construction to health care to tourism-related services—stand to benefit. But the people who could be helped are more than workers; they are students, parents, and veterans.

Data from 22 states that have not expanded reveal who could gain health coverage

We’ve taken a closer look at who stands to benefit from Medicaid expansion in the 22 states that have yet to extend the program. They include:

  • Young adults just starting out in life
    An estimated 1.5 million adults ages 19 to 24 have no option for affordable health coverage. These are young adults who are just getting started in life. Many may be in school or working part-time, while others may be starting a family. They don’t qualify for Medicaid in their state because they earn too much, but they don’t make enough to get help with marketplace health coverage. There’s a popular misconception that young adults don’t want health insurance, believing themselves to be invincible. To the contrary, a Kaiser Family Foundation study from 2013 showed that young people really do want coverage.
  • Adults ages 25 to 44
    An estimated 2.8 million adults ages 25 to 44 can’t get financial help to buy health insurance through the marketplace and can’t qualify for health coverage under Medicaid. This group includes parents who are working but make too much for their state’s Medicaid program. Many of these people struggle to support themselves and their children—and do so without health coverage. This group is left without any affordable options to get health coverage.
  • Older adults whose kids have grown
    An estimated 1.7 million low-income adults ages 45 to 64 are being left without an option for affordable coverage. That includes working adults and parents whose kids are grown and have left home. Across the states that haven’t extended coverage, none provide Medicaid coverage to adults who don’t have dependent children.
  • Parents with dependent kids
    In the states that haven’t extended health coverage, parents with dependent children can qualify for Medicaid only if they are extremely low-income—a median income of just 50 percent of poverty. That’s just $10,045 a year for a family of three, or a little more than $830 a month as the median. In many states, income eligibility is much lower. In states that haven’t extended coverage, parents making more than their state’s likely meager Medicaid eligibility level—but still less than the poverty level—don’t have any option for affordable health coverage. They are working hard to rear a family but don’t have any option for health insurance to make sure they can stay healthy and take care of their kids.
  • Working—but uninsured—adults
    In states that haven’t expanded Medicaid, an average of 57 percent of the adults who would benefit are working. These hardworking individuals hold down a variety of jobs—from fast food cooks to janitors, to construction workers, and home health aides.For example, in Florida, there are 85,000 people working in sales as cashiers, clerks, and retail salespeople who support industries—like tourism—vital to Florida’s economy, who would benefit from extended Medicaid coverage.
  • Uninsured Veterans and their spouses
    Not all eligible veterans enroll for VA coverage or live close enough to a VA facility for this health coverage to be a practical option. Furthermore, VA coverage does not always include family members. An estimated 359,000 veterans and their spouses are being left without an option for affordable health coverage because of state decisions to not extend Medicaid.

States that have chosen not to extend Medicaid coverage are leaving millions of hard working, low-income Americans without health coverage. But they are more than workers—they are young adults getting started, parents rearing families, parents whose kids are grown, and veterans and their spouses. It’s up to state lawmakers to give these citizens an opportunity to get health care coverage. It’s a decision they can make at any time.

Villers Fellow Melissa Burroughs contributed to this blog.