Table 4.

State Medicaid Officials’ Expectations Regarding Costs of the Medicaid Expansion, Stratified by Overall Budget Predictions¹⁰⁹

Survey Item	Prediction of Medicaid Expansion’s State Budget Impact Over the Next Decade
	Costly to State Budget	Savings for State Budget	P-value
Effect of Medicaid Expansion on Spending on Uncompensated Care
— No impact	1 (17%)	0 (0%)	0.67
— Small reduction	1 (17%)	4 (33%)
— Medium reduction	4 (67%)	7 (58%)
— Large reduction	0 (0%)	1 (8%)
Predicted impact of the ACA on Medicaid enrollment among previously-eligible uninsured individuals (the “woodwork effect”)
— No effect	0 (0%)	0 (0%)	0.17
— Small number of previously eligible individuals will enroll	0 (0%)	5 (42%)
— Moderate number of previously eligible individuals will enroll	6 (100%)	6 (50%)
— Large number of previously eligible individuals will enroll	0 (0%)	1 (8%)
State has a pre-existing state- or locally-funded insurance program for low-income adults that will be replaced by the ACA expansion
— Yes	2 (33%)	8 (67%)	0.18a
— No	4 (67%)	4 (33%)
Of those with pre-existing programs, percentage of 2014 expansion enrollment expected to come from individuals currently in those programs
— Less than 25%	1 (50%)	4 (50%)	0.89a
— Between 25% and 50%	0 (0%)	0 (0%)
— Between 50% and 75%	1 (50%)	3 (38%)
— More than 75%	0 (0%)	1 (12%)
Likelihood of federal government reducing the match rate (FMAP) in the next decade
— Nearly impossible	0 (0%)	3 (25%)	0.02
— Somewhat unlikely	0 (0%)	2 (17%)
— Possible	2 (33%)	5 (42%)
— Somewhat likely	3 (50%)	2 (17%)
— Nearly certain	1 (17%)	0 (0%)

^aA measure combining the question on the existence of a pre-existing program with the percentage of enrollment expected from that program also did not differ significantly across the two groups, p=0.21.