The Case for Medicaid Expansion

“Medicaid expansion” has become a buzzword throughout Georgia and around the country as people are demanding more options for affordable health care services. But what exactly would “Medicaid expansion” entail? Medicaid is a federal-state program, meaning it gives individual states the jurisdiction over how to structure their designated Medicaid funding, and in 2012 the Supreme Court ruled that states could even opt out of expanding the program [1]. Currently, 32 states have expanded Medicaid coverage, with several incoming governors across the nation planning on increasing that number. 

Individuals qualify for Medicaid when their income falls at or below 133% of the federal poverty line, which in 2018 was $25,100 for a household of four people [2]. Medicaid services vary based on states that expand the program and states that do not. Mandatory benefits provided include: inpatient and outpatient hospital services, preventive screenings, family planning services, rural health clinical services, and transportation to these services. In states that choose not to expand Medicaid, lower income residents would find themselves without access to necessary prescription drugs, physical therapy, occupational therapy, prosthetics, eyeglasses, dental services, chiropractic services, hospice, and several others medical services [3]. 

Expanding Medicaid also would mean covering more people with higher incomes who still cannot afford health insurance. States that do not expand Medicaid create a larger coverage gap of people who fall between the poverty line and the level of Medicaid eligibility. Over two million people in the United States waver in this uninsured status, with approximately 11% of those people living in Georgia. A disproportionate number of minority populations are affected by this issue, particularly African American people [4]. 

Reducing the number of people in the United States without health insurance will enhance many facets of our country, which currently hangs in the prospect of expanding Medicaid. Expanding the program will provide millions of people will access to primary/preventive care, which would reduce the number of patients in emergency rooms. There is substantial evidence that rural Americans in states that have expanded Medicaid have experienced benefits through access to health screenings and pharmaceuticals, which can result in positive generational health effects [5]. 

Higher rates of health insurance coverage allow individuals to contribute more to their state’s economy through other spending outlets. Even fiscally conservative states have seen economic gains; a 2018 study conducted by the University of Montana found that expanding Medicaid has been instrumental in stimulating revenue and generating jobs throughout Montana [6]. 

Out of all 77 studies about Medicaid expansion, only 4% found negative effects associated with the program, which was mostly attributed to longer wait times, but no studies found a decrease in the quality of care provided [5]. Expanding Medicaid to provide health insurance to more low-income Americans will decrease the uninsured rate, lower healthcare costs, improve health outcomes, and create ripples of progress throughout the country. 


[1] 01, 2012 Published: Aug. “A Guide to the Supreme Court’s Decision on the ACA’s Medicaid Expansion.” The Henry J. Kaiser Family Foundation, The Henry J. Kaiser Family Foundation, 15 May 2013, 

[2] Hill, Timothy B. “2018 Federal Poverty Level Standards.” CMCS Informational Bulletin, Department of Health and Human Services: Centers for Medicare and Medicaid Services, 6 Mar. 2018, 

[3] “List of Medicaid Benefits.”, Centers for Medicare & Medicaid Services, 

[4] Garfield, Rachel, et al. “The Coverage Gap: Uninsured Poor Adults in States That Do Not Expand Medicaid.” The Henry J. Kaiser Family Foundation, The Henry J. Kaiser Family Foundation, 13 June 2018, 

[5] Carroll, Aaron E. “Finally, Some Answers on the Effects of Medicaid Expansion.” The New York Times, The New York Times, 2 July 2018, 

[6] Japsen, Bruce. “Study Illustrates How Medicaid Expansion Can Pay For Itself.” Forbes, Forbes Magazine, 2 Apr. 2018,