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ACA Medicaid Expansions Didn't Increase States' Spending

State budget projections were accurate for federal, state, and Medicaid spending


TUESDAY, April 18, 2017 (HealthDay News) -- Federal funding insulated state budgets from increased spending related to Medicaid expansion, according to a study published in the April issue of Health Affairs.

Benjamin D. Sommers, M.D., Ph.D., from Harvard University, and Jonathan Gruber, Ph.D., from the Massachusetts Institute of Technology, both in Boston, used data from the National Association of State Budget Officers (fiscal years 2010 to 2015) and a difference-in-differences framework to assess the effects of the Medicaid expansion's first two fiscal years.

The researchers found that expansion led to an 11.7 percent increase in overall spending on Medicaid, which was accompanied by a 12.2 percent increase in spending from federal funds. State funds did not experience significant increases in spending as a result of the expansion. Nor did states significantly reduce spending on education or other programs as a result of Medicaid expansion.

"States' advance budget projections were also reasonably accurate in the aggregate, with no significant differences between the projected levels of federal, state, and Medicaid spending and the actual expenses as measured at the end of the fiscal year," the authors write.

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