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However, the court also ruled 5–4 that Medicaid expansion without the federal threat of defunding Medicaid in non-compliant states fell within the powers afforded by the Spending Clause to Congress. [27] Adoption of Medicaid expansion by individual states was effectively optional as a result of National Federation of Independent Business. [29]
The causes of this rate of uninsurance remain a matter of political debate. In 2018, states that expanded Medicaid under the ACA had an uninsured rate that averaged 8%, about half the rate of those states that did not (15%). [11] Nearly half those without insurance cite its cost as the primary factor.
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Several states have trigger laws where if federal funding drops, so would Medicaid expansion.
Where Your State Stands. Between December 2013 and December 2016, the national uninsured rate fell from 17.3 percent to 10.8 percent. The decrease is much greater in states that expanded Medicaid, and the gap between the top and bottom states has grown.
If Congress cuts federal funding, Medicaid expansion would be at risk in all states that have opted into it — even those without trigger laws — because state legislatures would be forced to ...
Wyoming is one of 10 states without Medicaid expansion, leaving thousands of residents like Dax without coverage. As a result, the Equality State also has one of the highest uninsured rates in the ...
As public support for expansion continues to grow in holdout states, North Carolina, the most recent Southern state to pass Medicaid expansion, may offer a glimpse of the future.