An Initiative of Smart Policy Works

Medicaid and Work, 2011 and 2016

ACA Medicaid expansion helped Illinois part-time workers and those in jobs that may not have offered health insurance gain coverage.

The ACA focused primarily on the working age population. In Illinois, the portion of people age 18-65 with insurance rose from 81% to 91%.

Medicaid accounted for the largest increase in working age people gaining coverage, adding more than 400,000 people to the rolls, a 45% inrease.

The Medicaid expansion led to significant increases in the number of people working part-time who were able to obtain coverage.

Medicaid provided a path to insurance for workers in occupations that historically had often not been insured, as well as among professional workers in "solo" occupations.

More than 80% of the Medicaid coverage gained by workers came from seven industries: retail, education and health, food and lodging, administrative support, manufacturing, transportation and warehousing, and construction.

Strong gains for the lowest-income households, with the percent of members insured through Medicaid increasing by around 8%, are masked by decline in the state's lower-income population overall.

Although the ACA made health insurance more affordable and accessible to to self-employed workers, the preponderance of growth in Medicaid coverage of workers was among people who work for wages.

The largest portion of Medicaid beneficiaries is white, and this group had the largest growth in Medicaid coverage under the expansion.

Immigrants, another group that has experienced difficulty achieving coverage, had substantial gains in coverage under the Medicaid expansion, especially among naturalized citizens.

People with disabilities gained coverage under the Medicaid expansion.

Source: American Community Survey, 2011 and 2016, from IPUMS-USA, University of Minnesota,, provided by Rob Paral and Associates.