Case Study
Estimating the enrollment impact of changes to Medicaid expansion
September 21, 2026
Situation
A client sought Avalere Health’s assistance to estimate the effects of rolling back or altering Medicaid expansion in states that expanded Medicaid eligibility to 138% of the Federal Poverty Level (FPL) under the Affordable Care Act (ACA).
Solution
Avalere Health utilized Centers for Medicare & Medicaid Services enrollment data and American Community Survey data to:
- Identify the number of individuals enrolled in the adult expansion population, specifically those individuals with incomes between 100% and 138% of the FPL
- Provide the number of individuals who would be affected by changes in eligibility by state, county, and legislative district
Success
Avalere Health supported the client by quantifying the number of individuals who would likely lose Medicaid coverage if states revert to pre-ACA coverage levels, as well as developing an interactive dashboard to view findings. This enabled to client to view scenarios and findings in real-time.
