Millions more Americans could gain Medicaid coverage if there is additional federal flexibility around expanding the program, according to a study from Avalere.
For the study, Avalere used 2016 data from the U.S. Census Bureau and CMS to project estimates for 2018.
Researchers said they found up to 6.9 million people from the states that didn't expand Medicaid could be eligible for the program if their states expanded coverage up to 100 percent of the federal poverty level.
Out of the 19 nonexpansion states, Texas and Florida could see the largest increase in Medicaid enrollment in this situation, with 1.8 million people and 1.1 million people newly eligible for coverage, respectively, according to the study.
Additionally, researchers said they found nearly 4 million people could move from Medicaid to the ACA exchanges if expansion states reduce their program eligibility from 138 percent of the federal poverty level to 100 percent of the federal poverty level. Out of the 31 expansion states and Washington, D.C., New York and California would see the most people move coverage, according to the study.
"Additional federal flexibility around Medicaid expansion could create new coverage options for low-income uninsured people living in nonexpansion states," said Elizabeth Carpenter, senior vice president at Avalere. "However, for those individuals currently enrolled in Medicaid and earning between 101 percent to 138 percent FPL, they may end up paying more for care under an exchange plan if their state changes eligibility for Medicaid."