Is federal health care funding distributed disproportionately among the states?
States that have opted not to offer low-income residents more access to health care coverage receive less federal heath care funding, relative to their populations. The Affordable Care Act expanded and funded Medicaid programs for low-income residents, but states may choose to opt out of those provisions. Twelve states continue to decline to participate.
Funding (including subsidies for private insurance under the Act, Medicaid support and other payments) is generally in line with population. Based on data compiled by the Urban Institute, California, with 12.1% of the U.S. population, receives about 12.5% of total funding. New York, with 5.9% of population, receives about 7.1%. Texas, which has opted out of Medicaid, has 9.1% of the nation's population but receives 7.1% of federal funding. South Carolina, with 1.5% of population, receives 1.3% of funding.