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Although Medicaid expansion under ACA was a de jure voluntary initiative for states, it was intended to be implemented nationally. [26] Opponents of the legislation described the conditioning of the increased funding for Medicaid on states opting into expansion as unconstitutionally coercive, making Medicaid expansion effectively mandatory.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
States that expanded Medicaid under Obamacare (37 as of 2019, including Washington, D.C.) had lower uninsured rates than states that did not. Inability to afford insurance was the primary reason cited by persons without coverage (46%).
Where Your State Stands. Between December 2013 and December 2016, the national uninsured rate fell from 17.3 percent to 10.8 percent. The decrease is much greater in states that expanded Medicaid, and the gap between the top and bottom states has grown.
The Affordable Care Act’s chief aim is to extend coverage to people without health insurance. One of the 2010 law’s primary means to achieve that goal is expanding Medicaid eligibility to more people near the poverty level. But a crucial court ruling in 2012 granted states the power to reject the Medicaid expansion.
The 10 states that saw enrollment decline the most account for nearly half (46%) of all child disenrollments since the COVID-era Medicaid and CHIP policies ended in early 2023.
So far, 38 states and Washington, D.C., have enacted Medicaid expansion programs. If North Carolina expanded its Medicaid access, roughly half a million uninsured residents would qualify for coverage.
Several states have trigger laws where if federal funding drops, so would Medicaid expansion.