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UNITED STATES

ROADMAP POLICIES AND STRATEGIES

EFFECTIVE POLICIES

EFFECTIVE STRATEGIES

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EXPANDED INCOME ELIGIBILITY FOR HEALTH INSURANCE

WHAT IS MEDICAID EXPANSION AND WHY IS IT IMPORTANT?

States can employ a number of strategies to increase health insurance coverage for their residents, and the most widely studied strategy is the expansion of Medicaid eligibility. Medicaid is a joint federal and state program that provides health insurance to low-income households, covering one in five Americans and 41.0% of all live births in the United States.1,2

The federal Patient Protection and Affordable Care Act, also known as the ACA, was signed into law in 2010. In addition to providing subsidies to purchase health insurance in the online Marketplace, the ACA expanded Medicaid eligibility for most adults with incomes at or below 138% of the federal poverty level (FPL), to begin in 2014. In 2012, the Supreme Court ruled3 that the federal expansion was unconstitutional, which allowed states to determine their own income guidelines and eligibility criteria.4

For states that have expanded Medicaid, the federal government currently covers 90% of the state’s Medicaid costs for the expansion population.5 States are responsible for paying the remaining 10% using general revenues, alcohol taxes, tobacco taxes, provider taxes, and other dedicated revenues and government contributions.6,7 As an incentive for nonexpansion states to expand Medicaid, the American Rescue Plan Act of 2021 (ARPA) offered a temporary additional 5 percentage point increase to the federal government’s share of a state’s Medicaid costs (the Federal Medical Assistance Percentage, or FMAP). The increase is still available for 2 years after expansion, despite the end of the public health emergency in May 2023.8,9

Because Medicaid Income Eligibility Varies Widely Across States, Many Individuals Lack Coverage 

The populations most affected by a state’s decision to expand Medicaid are previously ineligible childless adults, including childless women of reproductive age,10 and parents whose incomes fall between the pre-ACA income guidelines established in their state and 138% of the FPL. States that have not expanded Medicaid do not cover most childless, nonelderly adults,11 regardless of income level,12 and income eligibility thresholds for parents range from a low of 16% of the FPL in Texas to 100% of the FPL in Georgia and Wisconsin.

In most states, Medicaid income eligibility thresholds are higher for pregnant people than other adults, but pregnancy Medicaid coverage only typically lasts for 60 days postpartum, and then the person must switch to traditional Medicaid or use a subsidy to purchase health coverage on the Marketplace. In nonexpansion states, many of these new parents lose health insurance coverage after the postpartum period because their incomes are too high for traditional Medicaid, but not high enough (100% of the FPL) to receive subsidies on the Marketplace. 

Through options included in ARPA, as of July 2023, 47 states (including the District of Columbia) have moved to extend pregnancy Medicaid coverage to 12 months postpartum through state plans, Section 1115, or passing legislation.13

Expanding Medicaid Eligibility Allows More People to Access Necessary Care

In nonexpansion states, many parents with low incomes earn too much to qualify for Medicaid, and most childless adults are not eligible regardless of their income. Approximately 3.5 million uninsured adults would become newly eligible for Medicaid if the remaining nonexpansion states expanded the income eligibility for Medicaid to 138% of the FPL.14 Workers with low incomes in these states, including child care teachers, would be likely recipients of Medicaid coverage.15

Medicaid Expansion Can Help People Initiate Health Care Prior to Conception, a Critical First Step for Healthy Pregnancies and Births

Without expanded Medicaid eligibility, childless adults with low incomes may have limited access to family planning services, preventative care before conception, and prenatal care in the earliest stages of pregnancy. Access to health insurance in these important periods may lead to lower rates of maternal mortality and adverse birth outcomes, including infant mortality, low birthweight, and preterm birth.16

Expanding Medicaid Helps Keep Families Financially Stable

Families who have access to free or low-cost health services through Medicaid are less likely to be severely burdened by medical costs and less likely to incur medical debt, which may reduce families’ medical financial costs and free up resources to spend on other household needs.17,18,19 Further, individuals who previously avoided medical care due to high costs are more likely to access necessary health care, which may lead to improved physical and mental health outcomes.20,21

Search the Prenatal-to-3 Policy Clearinghouse for an ongoing inventory of rigorous evidence reviews, including more information on expanded income eligibility for health insurance.

WHAT IMPACT DOES MEDICAID EXPANSION HAVE?

Various studies have shown Medicaid expansion can help families access needed care and services, increase household resources, improve healthy and equitable birth outcomes, and improve child health and development. Medicaid expansion increases rates and the length of Medicaid coverage before and after pregnancy, decreases uninsurance rates, and increases the probability of timely and adequate prenatal care. 

Medicaid expansion also bolsters families’ economic security through reduced medical spending and debt. Furthermore, Medicaid expansion has been found to decrease family poverty rates, housing instability, and avoidance of health care due to cost barriers. 

Additional studies have found positive effects on healthy birth outcomes, such as preterm births, low birthweight, and maternal mortality. Benefits for child health and development include decreased rates of child neglect.

Medicaid Expansion Reduces Racial Disparities in Insurance Coverage, But More Research is Needed to Understand the Full Potential of Medicaid Expansion

Families of color are less likely to have access to affordable health insurance coverage.22 Medicaid expansion decreases uninsurance rates among Hispanic and multiracial women,23 increases Medicaid coverage rates among Hispanic and Black women,24 and increases the receipt of prenatal care among Hispanic women.25 These positive outcomes have a stronger effect size relative to outcomes observed for White women, which may reduce disparities across racial and ethnic groups.

The evidence suggests that Medicaid expansion leads to better birth outcomes, including reductions in maternal mortality rates for some women of color,26,27 but more research is needed to determine whether these results represent reductions in disparities in outcomes. Some studies show that Medicaid expansion reduces disparities in infant mortality rates between Hispanic infants28 and White infants,29 and reduces disparities in the rates of preterm births and very low birthweight among Black infants compared to White infants.30 Despite these positive findings, other studies find no evidence that Medicaid expansion reduces disparities in birth outcomes.31,32,33

Evidence does show, however, that the impact of Medicaid expansion on outcomes related to family financial stability, such as child support receipt, was more beneficial for people with higher educational levels and who identified as White.34 These results are important because they point to possibly exacerbated inequality rather than equity. More research is needed to understand the full potential of Medicaid expansion to reduce disparities beyond access to health insurance.

For more information on what we know and what we still need to learn about Medicaid expansion, see the evidence review on expanded income eligibility for health insurance.

WHAT PROGRESS HAVE STATES MADE IN THE LAST YEAR TO ADOPT AND IMPLEMENT MEDICAID EXPANSION?

In total, 40 states have adopted and fully implemented the Medicaid expansion under the ACA. This number includes South Dakota that began offering coverage for the first time in July 2023. As of October 1, 2023, North Carolina enacted, but had not yet implemented, Medicaid expansion due to delays with the state budget; coverage is scheduled to be available December 1, 2023. 

Of the 10 remaining states that have not yet expanded Medicaid, nine introduced legislation to adopt the policy in the last year.

Tracking State Policy Progress

Policy adoption does not typically happen quickly. States may introduce legislation several times before adopting a policy and take even more time to fully implement it. Every year we analyze state legislation and track states’ efforts toward adopting and fully implementing each of the effective policies in this State Policy Roadmap.

The figure below summarizes the legislative activity and progress states made toward adopting or extending Medicaid expansion in the year since the October 2022 Roadmap release. We analyze state legislation and ballot initiatives, pending and approved Section 1115 waivers with the Centers for Medicare & Medicaid Services (CMS), and Medicaid state plan amendments (SPAs) to document and summarize the progress states are making to expand Medicaid and extend coverage to additional populations.

In subsequent sections, we describe how states vary in the generosity and implementation of their state Medicaid programs.

Medicaid Expansion Became Law in South Dakota and North Carolina in the Last Year

In the past year, two states took action to expand Medicaid coverage – South Dakota and North Carolina. In November 2022, South Dakota voters approved a ballot initiative to expand Medicaid by constitutional amendment and the policy was fully implemented in July 2023. 

In early 2023, the North Carolina legislature enacted Medicaid expansion. Although the bill was signed into law by the governor in March 2023, implementation of Medicaid expansion was contingent on the passage of the state budget, which was delayed until September 2023. North Carolina Governor Cooper allowed the budget to become law in early October without his signature. Medicaid coverage will be available to the population covered by the expansion as of December 1, 2023.

Among Nonexpansion States, 9 Introduced Legislation to Expand Medicaid

As of October 1, 2023, 11 states have not yet fully implemented the expansion of Medicaid under the ACA, including North Carolina, which will implement Medicaid expansion in December 2023. Of the 10 remaining states that have not adopted Medicaid expansion, nine states considered, but did not pass legislation to adopt the policy. Wisconsin, which sets Medicaid eligibility for most childless adults at 100% of the FPL, is the only nonexpansion state that did not introduce legislation to expand Medicaid this year.

Legislative Barriers in Nonexpansion States Stall Progress

Among the 10 states that have not adopted Medicaid expansion, five states have adopted regressive policies to limit the approaches available to implement expansion. Alabama, Georgia, Kansas, and Tennessee all require legislative approval before the state can adopt and implement expansion. In Wisconsin, former Governor Walker signed a law in 2018 that effectively prohibits the Wisconsin governor from expanding Medicaid without some involvement from the state legislature.

7 Expansion States Introduced Legislation to Expand Medicaid Coverage to New Populations, and 2 States Were Successful

As of October 1, 2023, 40 states have fully implemented Medicaid expansion. Of these 40 states, three states (California, the District of Columbia, and Oregon) have implemented more generous policies to extend coverage beyond the ACA guidelines, including to adults with low incomes who were previously ineligible due to immigration status (California and Oregon) and to childless adults with incomes at or below 215% of FPL (District of Columbia). Colorado’s expansion to children and pregnant people who were previously ineligible due to immigration status will be effective in 2025.

Seven expansion states – Illinois, Maine, Nevada, New Jersey, New York, Rhode Island, and Vermont – introduced legislation to expand eligibility for Medicaid coverage, and two states – Maine and Nevada – successfully enacted new policies. Maine enacted legislation to prevent loss of Medicaid coverage during incarceration and to facilitate the application of Medicaid benefits for those transitioning out of incarceration. Nevada enacted legislation to extend Medicaid coverage to incarcerated individuals up to 6 months prior to release, rather than at the time of release, effective January 1, 2024.

Although unsuccessful, Illinois introduced legislation to expand Medicaid coverage (to all women of childbearing age and to 205% of the FPL). Several states introduced legislation to cover groups of people previously ineligible due to their immigration status (Nevada, New Jersey, New York, and Vermont). In Nevada, the governor vetoed a bill the legislature had passed to provide state-funded healthcare to pregnant people who are ineligible for Medicaid due to their immigration status; a different bill was ultimately enacted, as described above. Rhode Island introduced legislation to require that Medicaid enrollment be maintained or provided to all inmates in the first 30 days of incarceration and last 30 days of incarceration. As of October 1, 2023, the New Jersey legislature was still in session.

1 State Implemented Limited Medicaid Coverage with Work Requirements

Under the Trump administration, 13 states received CMS approval to add work requirements to their Medicaid programs by submitting Section 1115 waivers (Arizona, Arkansas, Georgia, Indiana, Kentucky, Maine, Michigan, Nebraska, New Hampshire, Ohio, South Carolina, Utah, and Wisconsin). Until this year, of those states, only Arkansas had ever implemented penalties for failure to comply with work reporting requirements. Arkansas’ work requirement was overturned by a federal judge in April of 2019 and in September 2021, following the Biden administration’s recission of waivers that included work requirements, Arkansas submitted a Section 1115 waiver request to CMS to seek approval of its new Medicaid program, which removed the work requirement.

Following litigation, Georgia implemented a new limited Medicaid coverage program called Pathways to Coverage; benefits became available in September 2023. Coverage is available to those with incomes below 100% of the FPL and because this is a partial expansion, Georgia receives their standard federal matching rate, rather than the higher rate they would receive if expanding coverage to the full expansion population. Georgia is the only state with an active work reporting requirement in Medicaid. Pathways to Coverage enrollees are required to work 80 hours each month, provide documentation to maintain their Medicaid coverage, and does not allow any exceptions for caregiving responsibilities. Because of these requirements, far fewer individuals are expected to receive coverage than are eligible based on income alone.35

Pregnancy Medicaid Coverage Lasts Only 60 Days Postpartum, But Most States Are Working to Extend It to 12 Months

Medicaid coverage for pregnant people typically only lasts through 60 days postpartum. Following the temporary state option included in ARPA, states could extend pregnancy Medicaid coverage to 12 months postpartum through state plan amendments (in addition to previously available options). The option for states to extend via state plan amendments through ARPA went into effect on April 1, 2022. The 2023 Consolidated Appropriations Act (CAA) made this temporary option permanently available to states. If states provide postpartum coverage through the Children’s Health Insurance Program (CHIP), the state option would need to include coverage through CHIP as well.

As of October 1, 2023, 47 states, both expansion and nonexpansion states, have acted to extend the Medicaid postpartum coverage period to 12 months through state plan amendments or Section 1115 waivers; 38 of these states have fully implemented 12-month postpartum coverage.

An additional nine states are planning to extend postpartum coverage, but the policy change has not been fully implemented. Utah’s planned extension limits access to coverage for those whose pregnancy ends in birth, miscarriage, stillbirth, or abortion due to rape, incest, or life endangerment. 

Only four states – Arkansas, Idaho, Iowa, and Wisconsin – have not extended Medicaid postpartum coverage to 12 months. Among the four states that have not yet implemented or are not yet planning to extend Medicaid postpartum coverage to 12 months, Wisconsin proposed extending postpartum coverage for a shorter period ranging from 90 days. Legislation to extend coverage failed this session in Arkansas and Iowa, and Idaho took no action to extend postpartum coverage.

For more information on the state policy levers to help maximize the effectiveness of policies that improve access to perinatal health insurance, including Medicaid expansion, see our State Policy Lever Checklists.

HOW DO STATES VARY IN ELIGIBILITY AND ACCESS TO HEALTH INSURANCE?

In Nonexpansion States, Most Childless Adults and Many Low-Income Parents are Not Eligible for Medicaid Coverage

In nonexpansion states, most childless adults are not eligible for coverage through Medicaid. Two exceptions are Georgia and Wisconsin, which provide coverage to adults with incomes at or below 100% of the FPL, or $14,580, although Georgia’s program has a work requirement, which may substantially limit eligibility. 

In contrast, in all expansion states, childless adults with incomes at or below 138% of the FPL ($20,120) are eligible for Medicaid, and the District of Columbia is even more generous, granting coverage to childless adults with incomes at or below 215% of the FPL ($31,347). The income level to qualify for Medicaid coverage in 2023 is based on the federal poverty level for the 48 contiguous states and the District of Columbia. Hawaii and Alaska have slightly higher federal poverty levels.

For parents with low incomes in nonexpansion states, income eligibility varies from a low of 16% of the FPL for a family of three in Texas ($3,978 annual income) to 100% of the FPL for a family of three in Georgia and Wisconsin ($24,860). 

In contrast, in expansion states, parents with incomes at or below 138% of the FPL for a family of three are eligible, with Connecticut (160% of the FPL or $39,776) and the District of Columbia (221% of the FPL or $54,941) setting more generous income guidelines for parents.

In Most States, Regardless of Expansion Status, Income Eligibility Guidelines are Typically Higher for Pregnant People

Medicaid coverage for pregnant people is typically set at a higher income eligibility threshold than for childless adults or parents, regardless of the expansion status of the state. However, the income eligibility thresholds vary considerably across states.

In 26 states, the income eligibility threshold for pregnant people is at least 200% of the FPL, and in three of these states (the District of Columbia, Iowa, and Wisconsin), the threshold is higher than 300% of the FPL. Iowa has the most generous threshold for pregnant people at 380% of the FPL.

In three states (Idaho, Louisiana, and South Dakota) the income eligibility threshold for pregnant people is only 138% of the FPL, which is similar to the threshold for parents in the expansion states of Idaho and Louisiana. A resolution passed this year in Louisiana to request the state to increase eligibility for pregnant people to 185% of the FPL.

Lack of Health Insurance Prevents Women of Childbearing Age from Accessing Health Care That Can Lead to Healthier Perinatal Outcomes and Stronger Financial Security

Access to health insurance allows women of childbearing age to seek affordable medical care prior to becoming pregnant and to begin prenatal care earlier once they become pregnant. Each of these behaviors is linked to healthier birth outcomes. In each state, the percentage of women of childbearing age with low incomes (defined as incomes below 138% of the FPL) who lack health insurance indicates the proportion of women in that state who could be served by expanding eligibility and access to Medicaid.

Currently, nearly half of income-eligible women lack health insurance in Texas, which has the highest uninsurance rate in the country, and the lowest Medicaid eligibility threshold; however, only 1.0% of income-eligible women lack health insurance in Vermont, a state that has expanded Medicaid coverage and has the lowest uninsurance rate in the country. On average, across states, approximately 1 in 5 (21.2%) income-eligible women lacks health insurance.

Unwinding of Continuous Coverage Provisions Presents New State Challenges

The pandemic ushered in a new era of policies designed to protect families’ access to health care coverage. With the Families First Coronavirus Response Act in March of 2020, Congress prohibited states from disenrolling individuals from Medicaid during the public health emergency (PHE). For more than 3 years, this continuous coverage provision allowed millions of people to maintain Medicaid coverage without interruptions. The 2023 Consolidated Appropriations Act (CAA) delinked the Medicaid continuous coverage requirement from the PHE, ending the continuous coverage on March 31, 2023. Beginning April 1, 2023, for the first time in 3 years, states could disenroll individuals who were no longer eligible because of their income.

Prior to the expiration of continuous coverage, experts estimated that approximately 15 million individuals risked losing Medicaid and CHIP coverage in this process.36 As of September 26, 2023, Kaiser Family Foundation estimated that at least 7.5 million Medicaid enrollees had lost coverage in the unwinding process to date, with wide variation in the termination rates across states, from 69% in Texas to 14% in Maine and Oregon.37

To mitigate coverage losses among individuals who remain eligible but whose coverage is at risk due to procedural reasons, states can complete renewals more slowly (as allowable by the federal government) and adopt policies to expand income eligibility for Medicaid to additional populations (e.g., expanding coverage to adults with incomes up to 138% of the FPL, extending postpartum Medicaid coverage from 60 days to 12 months, and adopting 12-month continuous eligibility for all children in Medicaid and CHIP, a policy the CAA will begin requiring for all states effective January 1, 2024). Three states – Colorado, Oregon, and Minnesota – have taken action to limit the number of people disenrolled from Medicaid following these policy changes.

  1. KFF. (n.d.) State Health Facts: Births Financed by Medicaid, 2021.  https://www.kff.org/medicaid/state-indicator/births-financed-by-medicaid/
  2. Rudowitz, R., Garfield, R., & Hinton, E. (2019, March 6). 10 things to know about Medicaid: Setting the facts straight. Kaiser Family Foundation (KFF). https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-setting-the-facts-straight/
  3. National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al. (US Supreme Court, 2012). US 11-393. https://www.law.cornell.edu/supct/pdf/11-393.pdf
  4. Perkins, J. (2012, July). Fact sheet: The Supreme Court’s ACA decision and its implications for Medicaid. National Health Law Program. https://healthlaw.org/resource/fact-sheet-the-supreme-courts-aca-decision-its-implications-for-medicaid/
  5. Rudowitz, R., Corallo, B., & Garfield, R. (2021, March 17). New incentive for states to adopt the ACA Medicaid expansion: Implications for state spending. KFF. https://www.kff.org/medicaid/issue-brief/new-incentive-for-states-to-adopt-the-aca-medicaid-expansion-implications-for-state-spending/
  6. Park, E. (2021, March 18). Medicaid learning lab. Session 2: Medicaid and CHIP financing. Georgetown University Health Policy Institute: CCF. https://ccf.georgetown.edu/2021/02/05/medicaid-learning-lab/
  7. Hayes, S.L., Coleman, A., Collins, S.R. & Nuzum, R. (2019). The fiscal case for Medicaid expansion. The Commonwealth Fund. https://www.commonwealthfund.org/blog/2019/fiscal-case-medicaid-expansion
  8. Park, E. (2021, March 18). Medicaid learning lab. Session 2: Medicaid and CHIP financing. Georgetown University Health Policy Institute: CCF. https://ccf.georgetown.edu/2021/02/05/medicaid-learning-lab/
  9. Park, E., & Corlette, S. (2021, March). American Rescue Plan Act: Health care provisions explained. Georgetown University Health Policy Institute: CCF. https://ccf.georgetown.edu/wp-content/uploads/2021/03/American-Rescue-Plan-signed-fix-2.pdf
  10. Reproductive age is defined as ages 15 to 44; state Medicaid expansion covers adults ages 19 to 64.
  11. Georgia and Wisconsin are two exceptions, which both provide coverage for adults with incomes at or below 100 percent of the FPL.
  12. To see the range of Medicaid eligibility requirements during the perinatal period, see the evidence review on expanded income eligibility for health insurance
  13. KFF. (2023, July 13). Medicaid postpartum coverage extension tracker. https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/
  14. Rudowitz, R., Drake, P., Tolbert, J., & Damico, A. (2023, March 31). How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All Sates Adopted the Medicaid Expansion? https://www.kff.org/medicaid/issue-brief/how-many-uninsured-are-in-the-coverage-gap-and-how-many-could-be-eligible-if-all-states-adopted-the-medicaid-expansion/
  15. McLean, C., Austin, L.J.E., Whitebook, M., & Olson, K.L. (2021). Early Childhood Workforce Index – 2020. Berkeley, CA: Center for the Study of Child Care Employment, University of California, Berkeley. From https://cscce.berkeley.edu/workforce-index-2020/report-pdf/
  16. Park, E., & Corlette, S. (2021, March). American Rescue Plan Act: Health care provisions explained. Georgetown University Health Policy Institute: CCF. https://ccf.georgetown.edu/wp-content/uploads/2021/03/American-Rescue-Plan-signed-fix-2.pdf
  17. Giled, S., Chakraborty, O., & Russo, T. (2017, August). How Medicaid expansion affected out-of-pocket health care spending for low-income families. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2017/aug/how-medicaid-expansion-affected-out-pocket-health-care-spending
  18. Kuroki, M. (2020). The effect of health insurance coverage on personal bankruptcy: Evidence from the Medicaid expansion. Review of Economics of the Household, 00, 1-23. doi:10.1007/s11150-020-09492-0
  19. Callison, K., Walker, B., Stoecker, C., Self, J., & Diana, M.L. (2021). Medicaid expansion reduced uncompensated care costs at Louisiana hospitals; May be a model for other states. Health Affairs, 40(3), 529–535. doi: 10.1377/hlthaff.2020.01677
  20. Wen, H., Druss, B.G., Cummings, J.R. (2015). Effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions. Health Services Research,50(6), 1787–1809
  21. Winkelman, T.N.A & Chang, V.W. (2018). Medicaid expansion, mental health, and access to care among childless adults with and without chronic conditions. Journal of General Internal Medicine, 33(3), 376–383.
  22. Garfield, R., Orgera, K., & Damico, A. (2021, January 21). The coverage gap: Uninsured poor adults in states that do not expand Medicaid. KFF. https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/
  23. Johnston, E.M., McMorrow S, Thomas, T.W., & Kenney, G.M. (2020). ACA Medicaid expansion and insurance coverage among new mothers living in poverty. Pediatrics, 145(5), e20193178. DOI: https://doi.org/10.1542/peds.2019-3178 [Expanded Income Eligibility for Health Insurance Evidence Review Study DD]
  24. Johnston, E.M., McMorrow S, Thomas, T.W., & Kenney, G.M. (2020). ACA Medicaid expansion and insurance coverage among new mothers living in poverty. Pediatrics, 145(5), e20193178. DOI: https://doi.org/10.1542/peds.2019-3178 [Expanded Income Eligibility for Health Insurance Evidence Review Study DD]
  25. Harvey, S. M., Oakley, L.P., Gibbs, S.E., Mahakalanda, S., Luck, J., & Yoon, J. (2021). Impact of Medicaid expansion in Oregon on access to prenatal care. Preventive Medicine, 143, 106360. https://doi.org/10.1016/j.ypmed.2020.106360 Received 17 July 2020; Received in revised form 30 October 2020; [Expanded Income Eligibility for Health Insurance Evidence Review Study EE]
  26. Wiggins, A., Karaye, I. M., & Horney, J. A. (2020). Medicaid expansion and infant mortality, revisited: A difference-in-differences analysis. Health Services Research, 55(3), 393-398. https://doi.org/10.1111/1475-6773.13286 [Expanded Income Eligibility for Health Insurance Evidence Review Study V]
  27. Eliason, E. L. (2020). Adoption of Medicaid expansion is associated with lower maternal mortality. Women’s Health Issues, 30(3), 147-152. https://doi.org/10.1016/j.whi.2020.01.005 [Expanded Income Eligibility for Health Insurance Evidence Review Study J]
  28. Wiggins, A., Karaye, I. M., & Horney, J. A. (2020). Medicaid expansion and infant mortality, revisited: A difference-in-differences analysis. Health Services Research, 55(3), 393-398. 6). https://doi.org/10.1111/1475-6773.13286
  29. Cook, A., & Stype, A. (2021). Medicaid expansion and infant mortality: the (questionable) impact of the Affordable Care Act. Journal of Epidemiology and Community Health, 75, 10-15. http://dx.doi.org.ezproxy.lib.utexas.edu/10.1136/jech-2019-213666 [Expanded Income Eligibility for Health Insurance Evidence Review Study GG]
  30. Brown, C. C., Moore, J. E., Felix, H. C., Stewart, M. K., Bird, T. M., Lowery, C. L., & Tilford, J. M. (2019). Association of state Medicaid expansion status with low birth weight and preterm birth. JAMA, 321(16), 1598–1609. https://doi.org/10.1001/jama.2019.3678 [Expanded Income Eligibility for Health Insurance Evidence Review Study A]
  31. Boudreaux, M. H., Dagher, R. K., & Lorch, S. A. (2018). The association of health reform and infant health: Evidence from Massachusetts. Health Services Research, 53(4), 2406–2425. https://doi.org/10.1111/1475-6773.12779 [Expanded Income Eligibility for Health Insurance Evidence Review Study W]
  32. Cook, A., & Stype, A. (2021). Medicaid expansion and infant mortality: the (questionable) impact of the Affordable Care Act. Journal of Epidemiology and Community Health, 75, 10-15. http://dx.doi.org.ezproxy.lib.utexas.edu/10.1136/jech-2019-213666 [Expanded Income Eligibility for Health Insurance Evidence Review Study GG]
  33. Eliason, E. L. (2020). Adoption of Medicaid expansion is associated with lower maternal mortality. Women’s Health Issues, 30(3), 147-152. https://doi.org/10.1016/j.whi.2020.01.005 [Expanded Income Eligibility for Health Insurance Evidence Review Study J]
  34. Bullinger, L.R. (2020). Child support and the Affordable Care Act’s Medicaid expansions. Journal of Policy Analysis and Management, 40(1), 42-77.doi:10.1002/pam.22238 [Expanded Income Eligibility for Health Insurance Evidence Review Study JJ]
  35. Gardner, A., Alker, J., & Cuello, L. An analysis of Georgia’s section 1115 Medicaid Pathways to Coverage Program. (2023). Georgetown University, Center for Children and Families. https://ccf.georgetown.edu/2023/06/27/an-analysis-of-georgias-section-1115-medicaid-pathways-to-coverage-program/
  36. Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.  (2022, August 19). Unwinding the Medicaid continuous enrollment provision: Projected enrollment effects and policy approaches (Issue Brief HP-2022-20) August 19, 2022. Available at https://aspe.hhs.gov/sites/default/files/documents/404a7572048090ec1259d216f3fd617e/aspe-end-mcaid-continuous-coverage_IB.pdf
  37. KFF (2023, September 26). Medicaid enrollment and unwinding tracker. https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-and-unwinding-tracker/
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