KFF November 27, 2024
Although health care did not figure prominently in the 2024 presidential election, with President-elect Trump returning to the White House and Republicans controlling Congress, significant changes to Medicaid are expected. One potential target for federal spending reductions is the Affordable Care Act’s (ACA) Medicaid expansion. The ACA expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($20,783 for an individual in 2024) and now provides states with an enhanced federal matching rate (FMAP) of 90% for their expansion populations. While the expansion was originally mandatory for states, a Supreme Court decision in 2012 effectively made it optional and as of November 2024 all but 10 states have adopted the expansion. Twelve states...
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