A "tremendous amount of movement" will occur whether Medicaid is expanded or not because of the federal law, Solsky said.
"In any kind of complex, wide-ranging change such as this ... there are going to be winners and losers. And it's sort of up to everybody to look across the silos and say, 'What is for the greater good,'" she said.
The report also looked at other economic impacts, including jobs. It estimates that the state would gain about 5,100 jobs between 2014 and 2020 if it expands Medicaid, compared to a gain of about 4,400 jobs without an expansion.
While federally subsidized health clinics and community mental health centers would see financial benefits from Medicaid expansion, hospital revenue would be greater without it, the report said.
Health systems, which include hospitals and the physician groups and other offices they own, would see an increase in net income of about $113 million under Medicaid expansion over the seven year period, but an increase of $158 million if Medicaid isn't expanded. That's because more people would end up covered by private insurance, Solsky said.
She said the Department of Health and Human Services isn't taking a position on whether Medicaid should be expanded but hopes the report helps frame the discussion for lawmakers and the governor.
"I do think that reading the tea leaves in terms of what the governor has signaled and what the Legislature has signaled, that there's a lot more traction in favor of Medicaid expansion than there was a few months ago," Solsky said.