The Affordable Care Act (ACA) contained the provision requiring States to significantly expand Medicaid eligibility. The Supreme Court, however, ruled that states had the option of implementing this provision. Thus, the change in Medicaid eligibility and subsequent enrollment varied significantly across states based largely on whether or not they were an expansion state. A recent PwC study finds that Nevada, Oregon and Colorado had the largest percentage increase (all >50%), but three states Alaska, Missouri, and Georgia actually experienced decreases in Medicaid enrollment.
Overall, 3/50 states experienced a decrease in enrollemnt, 4/50 states experienced no change, and 43/50 experienced an increase in Medicaid enrollment since 2013. In fact, 27/50 states experienced an increase in Medicaid enrollment of 10% of more.