Executive Summary

Medicaid touches all of us. Medicaid and CHIP help nearly 89 million new mothers, growing children, members of working families, and aging seniors.

Medicaid is not an “us versus them” issue.

Medicaid is us.

Medicaid and the COVID-19 public health emergency
Throughout the COVID-19 pandemic, Medicaid has functioned as intended, providing a health care safety net for Americans facing medical emergencies and economic dislocation. Following passage of the Families First Coronavirus Response Act in March 2020, Medicaid enrollees were granted continuous eligibility to the program for the duration of the COVID-19 public health emergency. As the U.S. emerges from the pandemic, this eligibility provision will be suspended once the COVID-19 public health emergency formally expires. An August 2022 analysis from the HHS Office of Health Policy in for the Assistant Secretary for Planning and Evaluation estimates that 15 million individuals will leave Medicaid following the expiration of the public health emergency.

Medicaid and maternal health. Medicaid currently covers more than 4 in 10 births in the U.S.; the program covers the highest proportion of births in Louisiana (62 percent), Oklahoma (51 percent), and Alabama (50 percent).¹ Expansion is of relevance in the wake of the Supreme Court’s decisions in Dobbs vs. Jackson Women’s Health Organization, which will significantly curtail access to abortion and women’s health services. The chilling effect that the Dobbs decision will have on pregnancy services – and other laws such as Texas S.B. 8, which allows vigilante plaintiffs to sue health providers and others suspected of providing abortion services – is estimated to increase already-high maternal mortality rates nationwide by as much as one-third.² The increase in maternal mortality is expected to be even higher for non-Hispanic Black people.

Medicaid expansion could mitigate maternal mortality rates exacerbated by the Dobbs decision. A Women’s Health Issues study found that states that expanded their Medicaid programs had a significantly lower rate of maternal mortality compared with non-expansion states.³

Medicaid benefits working Americans. Nearly 60 percent of all adults with Medicaid coverage work. Nearly half of them work for small businesses with fewer than 50 employees. The vast majority of those who are not have reasons for not working, such as certain illnesses or disabilities. Nearly two-thirds of older and disabled Americans rely on Medicaid to help pay for nursing homes and care, so that family members need not choose between being a caregiver or continuing to work.

Medicaid has become an issue of growing political salience at both the state and Federal level. This white paper tracks the role of Medicaid in multiple election campaigns since 2019. This white paper also provides data about the number of persons in each state and congressional district enrolled in Medicaid and CHIP, and the estimated number of Americans who have benefited from Medicaid expansion under the Affordable Care Act.

Read the report in full >
Interactive maps, by Congressional district >

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[1] March of Dimes. Medicaid coverage of births: United States, 2020. Online at http://tinyurl.com/yc7a85y7.

[2] Schreiber, Melody. “’A Matter of Life and Death’: Maternal Mortality Rate Will Rise without Roe, Experts Warn.” The Guardian, Guardian News and Media, https://tinyurl.com/286vvstv

[3] Eliason, Erica. “Adoption of Medicaid Expansion Is Associated with Lower Maternal Mortality.” Women’s Health Issues : Official Publication of the Jacobs Institute of Women’s Health, U.S. National Library of Medicine, https://tinyurl.com/2mnedhd2.