Consultant Deborah Bachrach said early results from states that have expanded their Medicaid program are showing significant results. “In the last 18 months, a lot of studies are coming out including one just last week out of the federal government on the economics,” she said. “Obviously, uninsured rates are dropping more quickly in states that expanded.” Beyond that, she said, states that haven’t expanded have nearly double the percentage of rural hospitals at risk of closure; hospital uncompensated care costs have dropped by large amounts – more than $1 billion in Arkansas alone – and state budgets have seen net positive impacts.

“Sometimes it’s more than enough to sustain the expansion past 2016,” she said. “In some states it’s a dent but it’s not enough, it really depends on your current programs. But every state is seeing savings, and in both Arkansas and Kentucky, the savings and new revenue were enough to cover the cost in 2021. There’s tons of studies behind this.”

Arkansas projects a net positive impact on its state budget of $637 million from 2017 to 2021. Kentucky has had a $300 million net positive impact on its state general fund in two years, and projects $820 million in savings from 2014 to 2021. New Mexico’s expansion is projected to create a $316 million surplus in its state general fund between 2014 and 2021.