Final answer:
Medicaid enrollment increased due to job loss and absence of health insurance, with states expanding Medicaid in previous decades and continuing with the Medicaid Expansion under Obamacare. State budgets have been pressured by Medicaid costs, and some states have cut back on benefits as a result.
Step-by-step explanation:
Enrollment in Medicaid has seen an uptick due to various economic pressures, particularly since the 2008 recession. States have faced increasing financial burdens partly due to the high cost of healthcare services covered under Medicaid. This has resulted in Medicaid consuming a significant portion of state budgets, behind only education in most cases. As more people lost jobs and health insurance, Medicaid enrollment swelled, exacerbating state budget strains and leading to reductions in optional medical services offered by the program.
To address the issue that low-paying jobs were sometimes just enough to disqualify a family from Medicaid but did not provide health insurance, many states expanded their Medicaid coverage in the 1980s and 1990s. This expansion allowed for the inclusion of the near-poor, with income levels up to 135% or even 185% of the poverty line, and further provided guarantees that children would not lose coverage if their parents found work.
Additionally, the Medicaid Expansion, part of the Affordable Care Act commonly known as "Obamacare," incentivized states to broaden eligibility standards for Medicaid. This move was aimed at granting public medical insurance to a larger number of low and moderate-income citizens, although not all states chose to participate initially.