Medicaid Expansion: Data-Driven Insights into Healthcare Needs and State 1115 Implementation Trends
June 16, 2025
This 10-slide presentation, Medicaid Expansion: Data-Driven Insights into Healthcare Needs, offers a focused analysis of the Medicaid Expansion population—non-disabled adults ages 19–64 with incomes up to 138% of the Federal Poverty Level—across more than 40 states. Using recent T-MSIS data, the deck highlights the high prevalence of chronic and behavioral health conditions within this group, while also detailing demographic trends among the approximately 16 million enrollees.
Developed by Matt Powers, Shreyas Ramani, Loren Anthes, and Lora Saunders, the presentation contextualizes health needs with Medicaid spending patterns, comparing the Expansion group to other eligibility categories, such as dual eligibles and children. It also breaks down pharmacy spending by therapeutic class, spotlighting common conditions like opioid use disorder. In light of recent federal legislative proposals such as H.R. 1, the deck explores how states are beginning to navigate policy changes through 1115 waiver activity—particularly around medically frail and good cause exemptions—offering early insight into likely implementation strategies.
