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Has Medicaid expansion in states improved health outcomes?

Protestors call for health care beneifts

People demonstrate in support of health care in 2017 in Montana, which expanded Medicaid under the Affordable Care Act.

William Campbell-Corbis via Getty Images

This fact brief was originally published by EconoFact. Read the original here. Fact briefs are published by newsrooms in the Gigafact network, and republished by The Fulcrum. Visit Gigafact to learn more.

Has Medicaid expansion in states improved health outcomes?

Yes.

Studies have shown that Medicaid expansion in states does lead to improved health outcomes.


The Patient Protection and Affordable Care Act (ACA) sought to reduce the number of uninsured Americans through federal government subsidies of Medicaid coverage expansion. This Medicaid expansion was made optional to states, and as of May 2024 there were 10 U.S. states that had not yet implemented it. A study comparing outcomes of expansion vs. non-expansion states found a significant reduction in mortality in states that expanded Medicaid.

Individuals aged 55 to 64 with either less than a high school degree or income under the threshold (138 percent of the federal poverty level) experienced a 9.4 percent drop in mortality after expansion as compared to non-expansion states. Furthermore, research on states that already expanded Medicaid found no clear change in overall spending from state funds due to offsetting savings in health care costs.

This fact brief is responsive to conversations such as this one.

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KFF Status of State Medicaid Expansion Decisions: Interactive Map

EconoFact Impact of Medicaid Expansion on State Budgets and Mortality

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The Critical Value of Indigenous Climate Stewardship

As the COP 30 nears, Indigenous-led conservation offers the best hope to protect the Amazon rainforest and stabilize the global climate system.

Getty Images, photography by Ulrich Hollmann

The Critical Value of Indigenous Climate Stewardship

In August, I traveled by bus, small plane, and canoe to the sacred headwaters of the Amazon, in Ecuador. It’s a place with very few roads, yet like many areas in the rainforest, foreign business interests have made contact with its peoples and in just the last decade have rapidly changed the landscape, scarring it with mines or clearcutting for cattle ranching.

The Amazon Rainforest is rightly called the “lungs of the planet.” It stores approximately 56.8 billion metric tons of carbon, equivalent to nearly twice the world’s yearly carbon emissions. With more than 2,500 tree species that account for roughly one-third of all tropical trees on earth, the Amazon stores the equivalent to 10–15 years of all global fossil fuel emissions. The "flying rivers" generated by the forest affect precipitation patterns in the United States, as well our food supply chains, and scientists are warning that in the face of accelerating climate change, deforestation, drought, and fire, the Amazon stands at a perilous tipping point.

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Image generated by IVN staff

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Draining the Safeguards

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Jabin Botsford/The Washington Post via Getty Images

Draining the Safeguards

A loyalty-forward government has formed right before our eyes. Jared Kushner has been tapped to help lead the Israel–Hamas talks. He wasn’t chosen for his expertise in delicate diplomacy; he was chosen because he’s the president’s son-in-law—and because some around him seem to treat his Jewish identity as if that alone were a qualification aligned with a pro-Israel posture. Identity and proximity are not expertise. That’d be like putting Linda McMahon in charge of the Department of Education because she once (seemingly!) went to school. Oh wait, we did that too. What are we doing here?

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Without leaders like Dwight Eisenhower we will once again find ourselves on the precipice of a "world devoid of hope, freedom, economic stability, morals, values and human decency," writes M. Dane Waters.
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On September 28, 2025, President Trump ordered the deployment of National Guard troops to American cities for domestic law enforcement, with Defense Secretary Pete Hegseth authorizing 200 Oregon National Guard members for a 60-day deployment to Portland. A federal judge temporarily blocked the move, calling the justification for military deployment "simply untethered to the facts." When the administration tried to circumvent the order by sending troops from other states, the judge expanded her ruling, blocking any federalized National Guard deployment to Oregon.

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