An ongoing series on the 11 states that refuse to expand Medicaid. Read other project stories.

Thirty-nine states have expanded Medicaid coverage as authorized by the 2010 Affordable Care Act, insuring more than 21 million  Americans and drawing billions of federal health care dollars into local economies.

Eleven states  — “The Holdouts” — haven’t: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Wisconsin and Wyoming. South Dakota voters approved Medicaid expansion on Nov. 8, to take effect in July 2023. Collectively, it’s estimated almost 4 million uninsured Americans could gain health coverage if every state expanded Medicaid.

“The Holdouts” is a reporting collaborative of more than a dozen newsrooms committed to shedding light on the people and places most impacted by lawmakers’ refusal to expand Medicaid coverage in those 11 states.

Collaborative Members

El Paso Matters
Georgia Public Broadcasting
Health News Florida
Indian Country Today
Kansas Reflector
North Carolina Health News
Salud America!
Texas Public Radio
The Tyler Loop
Wisconsin Health News
WUNC North Carolina Public Radio
WWNO New Orleans Public Radio
Wyoming Public Radio


The Commonwealth Fund
T.L.L. Temple Foundation
Fund for Investigative Journalism