Table 4.
Pre- and Post-Supreme Court of the United States (SCOTUS) PPACA Coverage Impact (Millions) Only States with Medicaid Federal Poverty Level ≥100% Take the Expansion
| 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Pre-SCOTUS ruling | ||||||||||
| Individual coverage | ||||||||||
| Insured | 32.6 | 31.3 | 45.0 | 46.9 | 47.0 | 45.3 | 43.7 | 42.0 | 40.4 | 38.9 |
| Medicaid | 31.7 | 32.1 | 41.9 | 42.6 | 43.5 | 44.9 | 46.1 | 47.4 | 48.7 | 50.0 |
| Uninsured | 48.9 | 50.9 | 28.5 | 27.1 | 27.3 | 28.8 | 30.3 | 31.9 | 33.4 | 34.9 |
| Group coverage | ||||||||||
| Insured | 152.6 | 152.4 | 144.9 | 137.7 | 131.8 | 132.2 | 132.8 | 133.8 | 135.1 | 136.8 |
| Take Medicaid coverage | 3.2 | 3.8 | 10.1 | 11.5 | 12.7 | 13.8 | 14.7 | 15.6 | 16.2 | 16.9 |
| Refuse coverage | 5.9 | 7.2 | 5.5 | 5.9 | 6.3 | 6.8 | 7.2 | 7.4 | 7.3 | 7.1 |
| Take individual coverage | 0.1 | 0.1 | 4.5 | 11.7 | 17.6 | 17.3 | 17.0 | 16.8 | 16.5 | 16.2 |
| Total coverage | ||||||||||
| Insured | 185.4 | 183.7 | 194.4 | 196.2 | 196.3 | 194.7 | 193.6 | 192.6 | 192.1 | 191.9 |
| Medicaid | 34.9 | 35.9 | 52.0 | 54.1 | 56.2 | 58.7 | 60.9 | 63.0 | 65.0 | 66.8 |
| Uninsured | 54.8 | 58.1 | 34.1 | 33.0 | 33.6 | 35.6 | 37.5 | 39.3 | 40.7 | 42.0 |
| Total | 275.0 | 277.7 | 280.5 | 283.3 | 286.1 | 289.0 | 291.9 | 294.8 | 297.8 | 300.7 |
| Post-SCOTUS ruling | ||||||||||
| Individual coverage | ||||||||||
| Insured | 32.6 | 31.3 | 49.5 | 50.4 | 49.2 | 46.2 | 43.2 | 39.7 | 36.4 | 33.3 |
| Medicaid | 31.7 | 32.1 | 33.4 | 34.4 | 35.8 | 37.4 | 39.0 | 41.0 | 43.1 | 45.1 |
| Uninsured | 48.9 | 50.9 | 32.6 | 31.8 | 32.8 | 35.4 | 37.9 | 40.6 | 43.1 | 45.4 |
| Group coverage | ||||||||||
| Insured | 152.6 | 152.4 | 147.2 | 140.8 | 135.8 | 137.1 | 138.6 | 140.3 | 142.3 | 144.5 |
| Take Medicaid coverage | 3.2 | 3.8 | 6.8 | 6.9 | 6.9 | 6.8 | 6.7 | 6.7 | 6.7 | 6.7 |
| Refuse coverage | 5.9 | 7.2 | 5.8 | 6.3 | 6.9 | 7.5 | 8.0 | 8.3 | 8.3 | 8.0 |
| Take individual coverage | 0.1 | 0.1 | 5.2 | 12.6 | 18.8 | 18.6 | 18.5 | 18.2 | 18.0 | 17.7 |
| Total coverage | ||||||||||
| Insured | 185.4 | 183.7 | 202.0 | 203.8 | 203.8 | 201.9 | 200.3 | 198.2 | 196.6 | 195.6 |
| Medicaid | 34.9 | 35.9 | 40.2 | 41.3 | 42.6 | 44.2 | 45.7 | 47.7 | 49.8 | 51.8 |
| Uninsured | 54.8 | 58.1 | 38.4 | 38.1 | 39.7 | 42.9 | 45.9 | 48.9 | 51.3 | 53.4 |
| 275.0 | 277.7 | 280.5 | 283.3 | 286.1 | 289.0 | 291.9 | 294.8 | 297.8 | 300.7 | |
| Net impact | ||||||||||
| Insured | 0.0 | 0.0 | 7.5 | 7.6 | 7.5 | 7.1 | 6.7 | 5.7 | 4.5 | 3.7 |
| Medicaid | 0.0 | 0.0 | −11.8 | −12.8 | −13.6 | −14.4 | −15.1 | −15.3 | −15.2 | −15.1 |
| Uninsured | 0.0 | 0.0 | 4.3 | 5.1 | 6.1 | 7.3 | 8.4 | 9.6 | 10.6 | 11.4 |
Note: States taking expansion: MN, DC, ME, NJ, WI, CT, IL, VT, RI, NY, MA, TN, DE, MD, AZ, CA, CO, and HI.