When states opt out of expanding Medicaid

If states do refuse the Medicaid expansion, what happens to the people who would have been covered under it? Second, what implications will opting out have for the Federal budget? In states that participate, everyone with incomes between the state's current Medicaid eligibility cutoff (for example, 26 percent of the Federal poverty line in Texas, which is less than $4,000 for an individual) and 133 percent of the poverty line (less than $15,000) will be covered by Medicaid. It's estimated that this would extend coverage to 1.4 million people in Texas.