Low-income uninsured adults in states that have not expanded Medicaid might save more than $1,000 per year, on average, in out-of-pocket costs if they could enroll in Medicaid rather than a subsidized silver plan in the Health Insurance Marketplace, according to a new analysis by a researcher at the Agency for Healthcare Research and Quality. The study measured family out-of-pocket health care spending in 2005-2010 among low-income adults who gained eligibility for Marketplace coverage because they lived in states that had not yet expanded Medicaid under the Affordable Care Act. It then compared those data with two scenarios for those adults: coverage in a Marketplace silver plan with financial assistance and enrollment in expanded Medicaid. The results indicate that their average out-of-pocket spending would have been $938 a year under Medicaid and $1,948 per year under the silver plan. The study was published online by Health Affairs.