Medicaid Expansion Under the ACA: How States Analyze the Fiscal and Economic Trade-Offs

This brief explores how state officials and stakeholders are analyzing the fiscal and macroeconomic implications of their choice about whether to expand Medicaid. It focuses on 10 of the 11 states that are participating in the Robert Wood Johnson Foundation’s (RWJF) health reform monitoring and tracking project. The discussion is divided into four sections: the legal and policy context in which states are deciding whether to expand Medicaid; the status of decision-making around Medicaid expansion in our 10 RWJF states; how the fiscal effects of Medicaid expansion are being analyzed; and how the macroeconomic effects of Medicaid expansion are being analyzed.