According to the report, expanding Medicaid would cost the state $2.84 billion over those years, but that would be balanced in part by $878 million in savings on uncompensated care.
The federal cost of expanding Medicaid in Pennsylvania over those years would be $37.84 billion, or 21.9 percent, more than not expanding Medicaid.
The report says the Patient Protection and Affordable Care Act will decrease the number of uninsured Pennsylvanians by 28.9 percent without expanding Medicaid, compared to 52 percent if expanding Medicaid.
"With the large increases in federal funding coupled with relative small increases in state Medicaid spending, together with the effects on coverage, state savings on uncompensated care, increased revenue for hospitals and other providers, and state fiscal gains that we could not estimate, there are strong incentives for states to adopt the Medicaid expansion," the report says.
The Supreme Court's PPACA ruling made Medicaid expansion optional for states. There is no set deadline for the states to decide, and Pennsylvania Gov. Tom Corbett has not yet announced his plans on the matter.