Ed Savela of the Progressive Democrats of America fires up the crowd at a Medicaid protest rally in Birmingham, Alabama: Kenny Walters

By Glynn Wilson –

MARION, Va. — The Council of Economic Advisers released a report on Wednesday detailing the negative effects on local economies and public health in states where Republican administrations failed to cooperate with the federal government and expand Medicaid.

The report, entitled Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid, indicates that states where governors and state legislatures refused to expand Medicaid denied millions of citizens access to health care, endangered their financial security as well as the overall health and well-being of residents and damaged state economies.

“The Affordable Care Act has expanded high‐quality, affordable health insurance coverage to millions of Americans. One important way in which the Affordable Care Act is expanding coverage is by providing generous financial support to states that opt to expand Medicaid eligibility to all non‐elderly individuals in families with incomes below 133 percent of the Federal Poverty Level,” the report’s authors say.

To date, 26 States and the District of Columbia have seized this opportunity, and since the beginning of the Affordable Care Act’s first open enrollment period, 5.2 million people have gained Medicaid or Children’s Health Insurance Program coverage in these states, “a tally that will grow in the months and years ahead as Medicaid enrollment continues,” the report indicates.

In contrast, 24 States have not yet expanded Medicaid — including many of the states that would benefit most and sometimes because state legislatures have defied even their own governors — and “denied health insurance coverage to millions of their citizens.”

Researchers at the Urban Institute estimate that, if these states do not change course, 5.7 million people will be deprived of health insurance coverage in 2016. Meanwhile, these states will forgo billions in federal dollars that could boost their economies.

This analysis uses the best evidence from the economics and health policy literatures to quantify several important consequences of states’ decisions not to expand Medicaid. That evidence, which is based primarily on careful analysis of the effects of past policy decisions, is necessarily an imperfect guide to the future, and the actual effects of Medicaid expansion under the Affordable Care Act could be larger or smaller than the estimates presented below, according to the authors.

“However, this evidence is clear that the consequences of states’ decisions are far‐reaching, with implications for the health and well‐being of their citizens, their economies, and the economy of the nation as a whole.”

In states like Alabama, where progressive Democrats have protested Governor Robert Bentley’s election year decision not to participate in national health care by expanding Medicaid in the state, billions of dollars and thousands of jobs have been sacrificed in the name of anti-government conservative politics.

The news organization Al Jazeera is working on a special report on how states have been negatively affected by Republican politics and it will be using some of our video coverage in the report. We will share the news report when it becomes available.