Opting Out of the Medicaid Expansion under the ACA: How Many Uninsured Adults Would not Be Eligible for Medicaid?

The Supreme Court ruling on the Affordable Care Act upheld the individual mandate and made the expansion of Medicaid coverage to nonelderly adults with incomes below 138 percent of the federal poverty level optional for states. In this brief, Urban Institute researchers estimate the number of uninsured Americans in each state who could be eligible for Medicaid if every state takes the option of expanding Medicaid coverage. Of 22.3 million uninsured Americans with incomes below 138 percent of the federal poverty level, 67 percent (15.1 million) are adults not currently eligible for Medicaid but who could be made eligible under the ACA’s Medicaid expansion.