As of December 2020, 36 states and the District of Columbia had expanded Medicaid eligibility under the Affordable Care Act (ACA). We find that if the remaining 14 states had expanded eligibility in 2020, 4.4 million fewer people would have been uninsured that year. Absent the COVID-19 pandemic, the difference would have been 3.8 million. Thus, Medicaid expansion in the remaining states would increase health coverage even more under the pandemic. We also find young adults have the highest uninsurance rates under current law and would gain more coverage from Medicaid expansion than any other age group. And though further expansion would not increase the already high Medicaid eligibility thresholds for children, more children would be enrolled as their parents seek such coverage. A growing body of literature shows Medicaid expansion has benefits beyond increasing health coverage, such as saving lives and increasing financial security. Expanded Medicaid eligibility has also resulted in net savings to many of the states that have expanded, which is even more important now given the strain the pandemic has placed on state and local budgets. And because states that have recently expanded Medicaid have often done so relatively quickly, it is not too late to expand eligibility during this time of increased need.
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