States that have not expanded Medicaid not only leave 6.7 million residents uninsured, but also forgo $424 billion in federal funds over 10 years that could boost economic activity, according to a report from the Urban Institute. Texas and Florida, for example, each will lose approximately $66 billion in federal funding, while North Carolina will lose $40 billion. Hospitals in the 24 non-expansion states also will lose the 31 percent boost in Medicaid funding that was intended to offset major cuts to their Medicare and Medicaid reimbursement. This means that hospitals in Texas, Florida and North Carolina will lose $34 billion, $23 billion and $11 billion, respectively.

Other findings include:

• In non-expanding states, Medicaid expansion would add 78,600 jobs in 2014, 172,400 jobs in 2015 and 98,200 jobs in 2016.

• In states that expand Medicaid, every $1 invested in Medicaid expansion will yield $13.41 in federal funds flowing into the state.

• Comprehensive fiscal assessments performed in 16 states found that expansion would help state budgets. These assessments considered effects in four categories: increased state costs because of new enrollees; state Medicaid savings; non-Medicaid savings; and increased revenue.

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