The expansion of Medicaid eligibility was one of the main features of the Affordable Care Act (ACA), which was passed in 2010.
Millions of low-income adults were able to obtain health coverage thanks to this action, particularly those who were ineligible for regular Medicaid and unable to pay for private insurance.
Congress might put millions of Americans’ health care at risk.
This expansion, which has been adopted by 40 states and Washington, D.C., since 2014, has expanded coverage to an estimated 21 million Americans and helped to bring about a record drop in the country’s uninsured rate.
The federal government pays 90% of the cost under the expansion, which is a larger commitment than the usual 57% match for other Medicaid recipients.
Advocates claim that by enabling working-class adults to access healthcare, this has improved communities and saved lives.
The roughly 770,000 Ohioans who joined Medicaid under the state’s 2013 expansion program are at risk of being kicked off under potential state and federal changes.
https://t.co/WuUcEYhbub— clevelanddotcom (@clevelanddotcom) April 7, 2025
However, detractors claim that the scope has expanded too much and the prices have skyrocketed.
With Donald Trump in the White House and Republicans regaining complete control of Congress, this long-standing policy is once again under threat.
Three states—Oklahoma, Missouri, and South Dakota—are dealing with a particularly challenging situation.
Even if Congress reduces federal funds, it would be practically hard to withdraw from Medicaid expansion because their state constitutions require participation.
Voters approved these constitutional amendments through ballot initiatives, which were intended to secure the expansion in states that had previously opposed it.
The risk paid off, but it’s now posing new difficulties.
In the event that Congress implements its proposed Medicaid cuts, which may reduce spending by up to $880 billion over the next 10 years, these three states will not be able to just drop out like other states with “trigger laws.”
Rather, they would have to seek difficult and time-consuming constitutional amendments or make difficult trade-offs to make up the revenue gap.
This could include tax increases or cuts to funding in other vital sectors like transportation and education.
The stakes are extremely high, as over 3.7 million people in these three states currently depend on the expansion projects.
Fearing political and economic repercussions, even some Republican lawmakers from these areas are resisting.
Millions of lives and the future of Medicaid are at stake as the budget battle in Washington intensifies.
This information has been sourced from Marca.
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