States that have expanded Medicaid under the Affordable Care Act (ACA) are better positioned to respond to the COVID-19 public health emergency and to prevent the ensuing economic downturn from worsening access to care, financial security, health outcomes, and health disparities, a new CBPP state by state analysis shows. The 15 remaining states should act swiftly to implement expansion to help their residents weather the crisis. Many people who could gain coverage through expansion are at elevated risk from the virus, whether because they face a high risk of becoming infected or a high risk of serious illness if they do. Expanding Medicaid in the remaining states could:
- Cover 650,000 uninsured “essential or frontline workers:” people whose jobs likely require them to show up for work during the pandemic, regardless of stay-at-home orders or other restrictions, such as hospital workers, home health aides, and grocery store workers.
- Provide coverage to millions of older adults, people with disabilities, and others with underlying health conditions that increase their risk of complications from the disease.
 Expansion has helped narrow racial and ethnic disparities in both health coverage and access to care, putting expansion states in a better position to respond to the higher COVID-19 infection and mortality rates that Black and Hispanic people and American Indians and Alaska Natives are experiencing in many places.
If the remaining states expanded, the majority of the uninsured people gaining Medicaid eligibility would be people of color. By providing health coverage for people who lose their jobs or experience sharp drops in income, expansion can help prevent this recession from widening racial gaps in access to coverage and care, as the Great Recession did.
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