States Did the state expand Medicaid?* How did the state expand Medicaid? In non-expansion states: Has there been legislative or administrative activity to pursue expansion in 2017?* How many uninsured adults could gain Medicaid if the state expanded?* United States 32 Yes, 19 No 7 states have approved waivers in place, 2 states have waiver/waiver amendment applications pending, 2 states are preparing waivers/waiver amendments for submission*; 25 states expanded through SPAs 4 States with Activity in 2017 4,031,000 Alabama No 187,000 Alaska Yes (9/1/2015) SPA Arizona Yes Approved waiver in place; Preparing waiver amendment for submission Arkansas Yes Approved waiver in place; Preparing waiver amendment for submission California Yes SPA Colorado Yes SPA Connecticut Yes SPA Delaware Yes SPA DC Yes SPA Florida No 746,000 Georgia No                                      431,000 Hawaii Yes SPA Idaho No 50,000 Illinois Yes SPA Indiana Yes (2/1/2015) Approved waiver in place; Waiver extension/amendment application pending at CMS Iowa Yes Approved waiver in place Kansas No Expansion legislation passed by the House and Senate was vetoed by Governor Brownback on 3/30/17. House vote to override the veto failed by three votes. 86,000 Kentucky Yes SPA; Waiver application pending at CMS Louisiana Yes (7/1/2016) SPA Maine No Expansion question will be put to voters on the ballot in November 2017. N/A Maryland Yes SPA Massachusetts Yes SPA Michigan Yes (4/1/2014) Approved waiver in place Minnesota Yes SPA Mississippi No 151,000 Missouri No 139,000 Montana Yes (1/1/2016) Approved waiver in place Nebraska No 36,000 Nevada Yes SPA New Hampshire Yes (8/15/2014) Approved waiver in place New Jersey Yes SPA New Mexico Yes SPA New York Yes SPA North Carolina No Governor Cooper announced plans to expand Medicaid through executive action shortly after taking office in January 2017. Court battle is ongoing between the Governor and legislators over whether the Governor has the authority to expand without the General Assembly’s approval. 341,000 North Dakota Yes SPA Ohio Yes SPA Oklahoma No 127,000 Oregon Yes SPA Pennsylvania Yes (1/1/2015) SPA Rhode Island Yes SPA 201,000 South Carolina No South Dakota No 24,000 Tennessee No 174,000 Texas No                                    1,023,000 Utah No 55,000 Vermont Yes SPA Virginia No Governor McAuliffe requested a budget amendment on 3/27/17 that would give him the authority to expand. Republican-led General Assembly rejected the amendment on 4/5/17. 201,000 Washington Yes SPA West Virginia Yes SPA Wisconsin No N/A Wyoming No 14,000 NOTES:  *Coverage under the Medicaid expansion became effective January 1, 2014 in all states that have adopted expansion unless otherwise noted. States counted as having legislative or administrative activity on expansion in 2017 include those in which the governor is directly pursuing Medicaid expansion, a bill to expand Medicaid has been approved in at least one house of the legislature, or the decision to expand will be up to voters in a state referendum. States counted as preparing waivers/waiver amendments for submission include states in the range of the waiver development process between beginning work on drafting a waiver and officially submitting the waiver to CMS. Number of uninsured adults who could gain Medicaid coverage if non-expansion states expand includes both individuals currently in the coverage gap (<100% FPL) and those who currently may be eligible for Marketplace coverage (100-138% FPL); US total is for all non-expansion states (including those marked as N/A in the table); state values may not sum to national total due to rounding. SPA: State Plan Amendment. N/A: Sample size too small for reliable estimate.

SOURCES: Kaiser Family Foundation tracking of state Medicaid expansion activity; MaryBeth Musumeci, Elizabeth Hinton, and Robin Rudowitz, Key Themes in Section 1115 Medicaid Expansion Waivers (Washington, DC: Kaiser Family Foundation, March 2017),

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State Medicaid Expansion Approaches