The 19 states that have not yet expanded Medicaid could reduce the number of uninsured by 4.3 million to 5.2 million people while claiming $7.14-$7.75 in federal dollars for each state dollar invested to finance expansion. Expanding Medicaid in these states would increase federal funding by $595.8 billion to $664.8 billion from 2018-2027, while raising state Medicaid costs by $82.5 billion to $90.8 billion. Residents would save between $84.1 billion and $90.7 billion.. Each comprehensive review in expansion states has found that expansion improved state budget balances, with savings and revenue from expansion exceeding the cost of higher enrollment.