States with lower per capita incomes would become larger net recipients of federal funds if they expanded Medicaid eligibility under the Affordable Care Act, according to a study by The Urban Institute with support from the Robert Wood Johnson Foundation.

The ongoing pandemic and resulting recession have created budget shortfalls in many states, which has revived longstanding debates about the distribution of federal dollars across states. Researchers compared the distribution of federal spending on Medicaid and the Children's Health Insurance Program (CHIP) with states' contribution to the federal treasury.

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