Updated August 28, 2023.

An ongoing series on the states that refuse to expand Medicaid.
An ongoing series on the states that refuse to expand Medicaid. Credit: Rob Dobi

Forty states have expanded Medicaid coverage as authorized by the 2010 Affordable Care Act, insuring tens of millions of Americans and drawing billions of federal health care dollars into local economies.

Ten states — “The Holdouts” — haven’t: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.

“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 10 states.

Since March 2022, when The Holdouts project published its first story, South Dakota and North Carolina have joined the list of Medicaid expansion 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
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