Year of Publication



Martin School of Public Policy and Administration

Degree Name

Master of Public Administration

Committee Chair

Dr. Ron Zimmer

Executive Summary

The issue I studied is the decision states have been afforded to expand Medicaid with the Affordable Care Act (ACA). I was curious to determine the health and economic impact on states that have and have not chosen to expand Medicaid. Specifically, I targeted Kentucky (expansion state) and Tennessee (non-expansion state). Tennessee and Kentucky are similar populations, have similar political inclinations, and are both very rural states. At its core, Medicaid expansion is an opportunity to improve health for lower-income and disabled Americans. However, there are economic implications associated with Medicaid expansion as well. The goal of this research is to determine if there are economic benefits associated with states choosing to expand Medicaid. If so, this is information that needs to be communicated with states that have not chosen to expand. The majority of the data collection for this study is administrative data. The administrative data will show the Medicaid enrollment numbers in each state and how they have changed since the ACA and Medicaid expansion, but it will also show other factors pertaining to individual’s well-being in each state such as earnings and employment for all counties in each state on from the period of 2010-2018.