State Policy
1.4 Million Uninsured in Ten Non-Expansion States Remain in Medicaid Coverage Gap
An analysis estimates 1.4 million uninsured individuals in the ten states that have not adopted Medicaid expansion remain in the coverage gap — earning too much for traditional Medicaid but too little to qualify for Marketplace premium tax credits. This population includes working adults, people of color, and individuals with disabilities. These individuals are ineligible for Medicaid because their states have not adopted the ACA's expansion to adults up to 138% of the federal poverty level and ineligible for Marketplace subsidies, which begin at 100% FPL. The analysis highlights the continued state-by-state variation in Medicaid eligibility and access to affordable coverage.
Why it mattersThe coverage gap population represents ongoing uncompensated care costs for safety-net providers and forgone federal matching funds in non-expansion states, with direct implications for state budget decisions and Medicaid program scope.