Figure G

The 17 highest-union-density states have all adopted the Affordable Care Act’s Medicaid expansion: Number of high-, medium-, and low-union-density states that had adopted the Medicaid expansion as of 2019

Expanded Medicaid Did not expand Medicaid
Low 5 12
Medium 12 5
High 17 0

 

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Notes: Union density is defined as the share of workers in the state who are represented by a union, including union members and other workers who are covered by a union contract, based on the variable “union” from EPI extracts of CPS-ORG microdata. Low-union-density states are the 17 states with the lowest average union densities from 2015–2019 (all less than 8%). Medium-union-density states are the 17 states (including D.C.) in the middle of the union-density rankings (with union densities ranging from 8.3% to 13.3%). High-union-density states are the 17 states with the highest average union densities from 2015–2019 (greater than or equal to 13.5%). See Table 1 for more detail about these groupings.

Union density is defined as the share of workers in the state who are represented by a union, including union members and other workers who are covered by a union contract, based on the variable “union” from EPI extracts of CPS-ORG microdata. Low-union-density states are the 17 states with the lowest average union densities from 2015–2019 (all less than 8%). Medium-union-density states are the 17 states (including D.C.) in the middle of the union-density rankings (with union densities ranging from 8.3% to 13.3%). High-union-density states are the 17 states with the highest average union densities from 2015–2019 (greater than or equal to 13.5%). See Table 1 for more detail about these groupings. We average union density data across 2015 to 2019 for each state to give a more accurate estimate of states’ typical unionization rates over time. We do not include data beyond 2019 in our averages, to avoid any potential distortions related to the 2020–2021 COVID-19 pandemic and ensuing recession. To maintain consistency with avoiding 2020–2021 COVID-19 distortions, we examine Medicaid expansion status as of 2019. Therefore Idaho, Kentucky, Maine, and Montana, which expanded Medicaid in 2019, are grouped in the “Expanded Medicaid” category, while Arkansas, Missouri, Nebraska, Oklahoma, and Utah, which expanded Medicaid in 2020 or 2021, are listed in the “Did Not Expand Medicaid” category. Missouri and Nebraska are medium-union-density states while Arkansas, Oklahoma, and Utah are low-union-density states.

Sources: EPI analysis of 2015–2019 Current Population Survey Outgoing Rotation Group (CPS-ORG) microdata for all workers ages 16 and older; Kaiser Family Fund, “Status of State Medicaid Expansion Decisions,” September 8, 2021.

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