The 10-year total cost to expand Medicaid among non-expansion states adds up to approximately $31.6 billion, according to an Urban Institute report.
The states that have not expanded Medicaid that have the highest 10-year total cost include:
1. Texas — $5.7 billion
2. Florida — $5.4 billion
3. North Carolina — $3.1 billion
4. Pennsylvania* — $2.8 billion
5. Georgia — $2.5 billion
6. Tennessee — $ 1.7 billion
7. Missouri — $1.6 billion
8. Virginia — $1.3 billion
9. Louisiana — $1.2 billion
10. South Carolina — $1.2 billion
Considering that for every $1 invested in Medicaid expansion, $13.41 in federal funds flows into the state, non-expansion states are passing up almost $423.6 billion in federal Medicaid funds from 2013 to 2022.
*Pennsylvania's plan to use federal Medicaid expansion funding to launch a program that will promote affordable care and increase access to care for the uninsured has since been approved by HHS.