Report: Cities in states expanding Medicaid could see big drops in the uninsured

Expanding Medicaid under the new health care law would do a lot to slash the number of uninsured people, at least in some of the nation’s largest cities, according to a new report.

A review of 14 diverse big cities finds that the cities in states that are expanding the low-income health care program under the Affordable Care Act will see roughly twice the decline in the number of insured compared to cities in states not opting for the expansion, according to an analysis by the Robert Wood Johnson Foundation and the Urban Institute.

Three states are still debating whether to implement the expansion, while 21 have declined it, according to a count from last week by the Kaiser Family Foundation.

The seven cities in states expanding the program will likely see the number of uninsured drop an average 57 percent, while the remaining seven cities will see an average 30 percent drop, the report finds. The projected declines range from 25 percent in Atlanta, Ga., which isn’t expanding, to 66 percent in Detroit, Mich., which is.

Medicaid expansion would affect large portions of each city reviewed, but it would have an especially huge impact on four of the 14. More than half the population in Detroit, Memphis, Miami and Philadelphia, would be eligible for Medicaid after expansion, but only Detroit is in a state opting for expansion.

Medicaid is just one aspect of the law. Combine its impact with the law’s subsidies, and more than half the population in all but one city would be eligible for some kind of insurance assistance, the report’s authors find. The resulting flow of revenue to the cities would be a boon to their economies, the authors argue.

New federal spending from this year to 2023 would range from $1.9 billion in Atlanta to as much as $27 billion in Los Angeles, where the state is implementing the expansion.

Niraj Chokshi reports for GovBeat, The Post's state and local policy blog.
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