Who Would Have Health Insurance if Medicaid Expansion Weren’t Optional

By KEVIN QUEALY and MARGOT SANGER-KATZ,

A new data set suggests that more than three million people would have gained health insurance across 24 states if the Supreme Court had ruled differently.

In 2012, the Supreme Court ruled that a cornerstone of the Affordable Care Act — its expansion of Medicaid to low-income people around the country — must be optional for states. But what if it had ruled differently?

More than three million people, many of them across the South, would now have health insurance through Medicaid, according to an Upshot analysis of data from Enroll America and Civis Analytics. The uninsured rate would be two percentage points lower.

Today, the odds of having health insurance are much lower for people living in Tennessee than in neighboring Kentucky, for example, and lower in Texas than in Arkansas. Sharp differences are seen outside the South, too. Maine, which didn’t expand Medicaid, has many more residents without insurance than neighboring New Hampshire. In a hypothetical world with a different Supreme Court ruling, those differences would be smoothed out.

And that was the idea behind the Affordable Care Act.

More From The New York Times: