Skip to content
Search

Latest Stories

Follow Us:
Top Stories

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.

Sources

KFF Status of State Medicaid Expansion Decisions: Interactive Map

EconoFact Impact of Medicaid Expansion on State Budgets and Mortality


Read More

The dome of the United States Capitol Building in Washington, D.C., stands tall against a blue sky with the American flag waving proudly

A look at this week's congressional agenda, including House votes on Iran, Ukraine, FISA, appropriations, and key legislative priorities.

Getty Images, aire images

Legislative Preview for June 1, 2026

There will be plenty of coverage around the likely drama involved in picking up where House and Senate Republicans left off before this most recent week off. (For a recap, see our last post.) So we’re not going to go into any detail about what might happen with the reconciliation bill (originally only for two departments in the Department of Homeland Security; now enlarged with funding for the President’s ballroom project and overshadowed by the announcement of the President’s plan to pay off political allies with funds from the Department of Justice) or the FISA extension or the housing bill that’s been pingponging between chambers because you can read in sources like Politico about these marquee issue.

We will note that the Iran War resolution postponed in the House before the recess may be up for a vote this week, along with a resolution to remove US troops from Lebanon and a discharge petition (number 8) to put forward a bill authorizing support for Ukraine. Three privileged resolutions, of which one is a discharge petition (meaning it has 218 co-sponsors meaning at least a few House Republican co-sponsors), is a lot for one week. Especially when all three are expressing opposition to various administration stances and might get some House Republican votes.

Keep ReadingShow less
Can Governing Survive Without Continuity?
white and black quote board
Photo by Brendan Beale on Unsplash

Can Governing Survive Without Continuity?

Modern societies depend on continuity.

Electric grids are built over decades. Infrastructure systems require long investment cycles. Defense planning depends on sustained procurement and strategic consistency. Climate adaptation, energy systems, artificial intelligence governance, public health preparedness, and fiscal stability all require institutions capable of maintaining long-term priorities across multiple administrations.

Keep ReadingShow less
Can Coalitions Built on Opposition Still Govern?

Supporters of President Donald Trump, February 09, 2024 in Harrisburg, Pennsylvania.

(Photo by Spencer Platt/Getty Images)

Can Coalitions Built on Opposition Still Govern?

Political parties are supposed to do two things at once: win elections and govern. Those are not the same skill.

Winning elections requires assembling coalitions large enough to secure power. Governing requires maintaining enough internal agreement to make decisions, negotiate trade-offs, allocate resources, and sustain policy direction once power is achieved.

Keep ReadingShow less
The Fragile Promise of the Ballot
black and white love print crew neck shirt
Photo by Cyrus Crossan on Unsplash

The Fragile Promise of the Ballot

Recent Supreme Court decisions such as Shelby County v. Holder and Brnovich v. Democratic National Committee were not just redefinitions of election law; they marked a critical shift away from the federal government’s duty to ensure equal ballot access—a duty fundamental to democracy.

The consequences were swift and broad. Within hours, Shelby County, Texas, imposed strict voter ID rules that federal officials had previously blocked under the Voting Rights Act’s pre-clearance provisions. Soon after, North Carolina reduced early voting and eliminated same-day registration. Across parts of Alabama, Georgia, and other Southern states, polling places closed or moved, often in communities with large Black populations. What once required federal review could now proceed quickly.

Keep ReadingShow less