As part of the Affordable Care Act’s (ACA) broader goal of expanding health insurance coverage, states are incentivized through increased federal funding to extend Medicaid benefits to residents with incomes up to 138% of the federal poverty level.
The federal government originally intended to expand Medicaid eligibility in every state by withholding federal Medicaid funding from states that refused to expand, but a 2012 Supreme Court ruling on the ACA stipulated that the federal government could not withhold funding from states that do not expand Medicaid. This effectively made Medicaid expansion voluntary and left the decision to participate to state leaders. As of 2019, more than 30 states have chosen to expand Medicaid.
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