Medicaid by the Numbers: Cuts Would Harm Hundreds of thousands

By Brandon Novick

Created in 1965, Medicaid gives complete medical insurance for tens of hundreds of thousands of Individuals who’ve low incomes or qualifying disabilities. As the general price of healthcare has skyrocketed in the USA, federal spending on Medicaid has risen as properly, main President Trump and Congressional Republicans to focus on this system as a spot for important cuts.

One main avenue for chopping this system is eliminating or sharply lowering the Medicaid enlargement beneath the Reasonably priced Care Act. Medicaid – whereas operated by the states – is financed by each the federal authorities and every respective state. The ACA’s enlargement sharply elevated federal funding if states accepted the extra assist in order that adults with incomes as much as 138% of the federal poverty stage (FPL) would qualify for Medicaid protection (in 2025, this interprets to $21,597 for a single individual or $44,367 for a household of 4). At the moment, 40 states plus Washington, D.C. have accepted the enlargement whereas 10 states haven’t.

Proponents of chopping Medicaid additionally usually assist imposing work necessities, with the underlying assumption that individuals counting on this system have to be pushed to enter the job market. Nevertheless, this framing is wholly unfaithful; the overwhelming majority of Medicaid beneficiaries maintain jobs or are engaged in caregiving and faculty. Slicing Medicaid will merely deny well being care to hundreds of thousands of hardworking Individuals.

What follows is a group of key information factors, demonstrating the realities of the Medicaid program and who cuts would most hurt.

Who’s Lined
72.3 million

As of October 2024, 72.3 million Individuals are enrolled in Medicaid. This quantity rises to 79.3 million when together with the Kids’s Well being Insurance coverage Program (CHIP), which equally gives medical insurance to low-income kids. Total, 40.6 million adults and 36.8 million kids obtain well being care protection by way of Medicaid/CHIP.

30%

As Medicaid relies on household revenue, hundreds of thousands of Individuals fluctuate out and in of this system. In 2023, round 30% or 100.1 million Individuals had been enrolled in Medicaid in some unspecified time in the future.

>25%

Some states depend on Medicaid greater than others. In 2022, seven states had over 1 / 4 of their inhabitants enrolled in this system: New Mexico (33.5%), Louisiana (32.4%), New York (28.5%), Kentucky (28.3%), West Virginia (28.2%), Arkansas (27.4%), and California (26.8%).

39.5%

A plurality (39.5%) of Medicaid beneficiaries in 2023 had been white, adopted by Individuals of Hispanic (29.9%), Black (18.5%), a number of race (6.5%), Asian/Native Hawaiian or Pacific Islander (4.7%), and American Indian or Alaska Native (1.0%) identities.

17%

Medicaid gives essential well being care protection for a lot of rural Individuals, as 17% of Medicaid enrollees in 2021 lived in rural areas, roughly matching the % of rural Individuals total. In a number of states nevertheless, the proportion of non-elderly adults coated by Medicaid is far larger: Arizona (35.9%), New York (33.9%), New Mexico (31.6%), Louisiana (30.2%), Kentucky (28.5%), and West Virginia (25.5%).

68%

Medicaid recipients are particularly more likely to be white in rural areas in comparison with city areas, as 68% of rural beneficiaries in 2020 had been white in comparison with simply 38% in city areas. Nevertheless, white Individuals nonetheless made up the plurality of beneficiaries in city areas, adopted by Hispanic Individuals at 30%.

The Reasonably priced Care Act Medicaid Growth
21 million

In 2022, 21 million Individuals obtained well being protection instantly on account of the ACA’s Medicaid enlargement.

2.72 Instances Larger

The ACA’s Medicaid enlargement sharply lowered the burden of uncompensated take care of hospitals (well being care that sufferers can not pay for themselves and isn’t coated by insurance coverage). In 2021, uncompensated care prices had been simply 2.5% of complete hospital working bills in Medicaid enlargement states, in comparison with 6.9% in states that didn’t broaden Medicaid (round 2.72 instances higher).

19,200

A 2021 evaluation revealed within the The Quarterly Journal of Economics – a peer-reviewed educational journal – estimated that 19,200 Individuals lived who in any other case would have died on account of dwelling in a state that adopted the Medicaid enlargement. Conversely, they calculated that 15,600 Individuals died in states that rejected the enlargement, and these folks would have lived in any other case.

$3.4 billion

By offering well being protection to Individuals who in any other case would lack insurance coverage, Medicaid has considerably lowered the quantity of medical debt Individuals maintain. In simply the primary two years after its implementation, the ACA’s Medicaid enlargement in the reduction of unpaid medical payments despatched to debt collectors by $3.4 billion and medical bankruptcies by 50,000.

2.5 Instances Larger

Uninsured charges for American Indians and Alaskan Natives are among the many highest within the nation. The ACA’s Medicaid enlargement halved their uninsured charges from 30% in 2013 to fifteen% in 2022 amongst non-elderly adults in enlargement states. Comparatively, the uninsured fee fell from 30% to solely 24% in non-expansion states, that means that the decline was 2.5 instances higher in enlargement states.

690,000

By offering protection and lowering out-of-pocket bills, the Medicaid enlargement additionally sharply lowered the variety of Individuals dwelling in poverty. From 2010 to 2016, the Medicaid enlargement lifted round 690,000 Individuals out of poverty.

Who Would Be Impacted by Medicaid Cuts
4.3 million

Round 4.3 million folks would lose their Medicaid protection on account of dwelling in 12 states with set off legal guidelines that remove or scale back Medicaid eligibility if federal funding for the ACA’s Medicaid enlargement is lower.

36 million

Up to 36 million Individuals may lose their Medicaid protection on account of not too long ago recommended proposals to impose work necessities by Congressional Republicans. Whereas a majority of Medicaid beneficiaries do work, previous experiences present that bureaucratic pink tape and administrative burdens would considerably damage enrollment, particularly on condition that Individuals should re-enroll no less than annually.

92%

Whereas proponents of chopping Medicaid by way of imposing work necessities usually counsel or suggest that Individuals counting on this system are lazy and must work, the fact is that the majority are working in some capability. Amongst adults aged 19-64, 92% with Medicaid protection in 2023 had been working full (44%) or half (20%) time or didn’t work on account of caregiving (12%), sickness/incapacity (10%), or faculty (7%).

2.3%

In July 2023, Georgia – a state that has not adopted the Medicaid enlargement from the ACA – started its Pathways to Protection program which carried out work necessities for low-income adults to enroll in Medicaid. Nevertheless, solely 2.3% or 5,500 of the anticipated 240,000 folks that had been probably eligible for this system truly obtained protection by November 2024.

$26 million

Georgia spent over $26 million on its Pathways to Protection program inside its first yr, with greater than 90% of the prices going in direction of administration and consulting quite than precise well being protection.

50.4%

Whereas Medicaid/CHIP recipients do earn low incomes, round half of households earned greater than the brink of 138% of the FPL set by the ACA enlargement in 2023. 50.4% of people with Medicaid/CHIP protection earned greater than 138% of the FPL ($21,597 in revenue for a single individual or $44,367 for a household of 4), and 21.9% had household incomes between 200-399% of the FPL (between $31,300-$62,600 [single] and $64,300-$128,600 [family of four]). Many states permit people to obtain Medicaid at larger revenue ranges than 138% of the FPL if they’re kids, disabled, or pregnant.

33%

Medicaid additionally covers folks with qualifying disabilities, and 33% of Individuals enrolled in this system reported having a incapacity in 2021. This determine is double the speed of Individuals total who report having a incapacity.

11%

Whereas a third of Medicaid recipients reported having a incapacity, solely round 11% truly obtained their Medicaid protection due to a incapacity. This actuality is a results of the strict definition of incapacity set forth by the Supplemental Safety Revenue (SSI) Program.

37%

Many Individuals with disabilities actively work whereas receiving protection, as 37% of grownup Medicaid beneficiaries with a incapacity who will not be coated by SSI, Social Safety Incapacity Insurance coverage (SSDI), or Medicare labored in 2023.

7.9%

Whereas advocates of chopping Medicaid level in direction of its rising and important contribution to federal spending, Medicaid spending grew 7.9% in 2023 which is lower than the expansion in each Medicare (8.1%) and personal medical insurance (11.5%). Whole spending – $871.7 billion – was additionally smaller in comparison with Medicare ($1.0 trillion) and personal medical insurance ($1.5 trillion), that means that Medicaid is the smallest contributor to rising medical insurance expenditures.

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