Final answer:
Many states have yet to expand their Medicaid programs under the Affordable Care Act, with variation in coverage due to states' autonomy in administering their programs. Medicaid, established in 1965, aims to provide medical insurance to low-income people, but differences in state implementation lead to uneven coverage.
Step-by-step explanation:
Although federal guidelines for Medicaid provide a framework, many states have yet to expand their Medicaid programs. Under the Affordable Care Act (ACA), often referred to as "Obamacare," expansion was put forth to increase eligibility and offer medical insurance to a broader range of low and moderate income citizens. However, the decision to expand is left to the states, and several, particularly in conservative regions like the Midwest and South (with the exception of Maine), have chosen not to do so.
Congress created Medicaid in 1965, as a joint effort between state governments and the federal government. States have significant leeway to administer their programs, determine the level of benefits, and set eligibility requirements. This autonomy means that Medicaid can vary substantially across different states. While the program aims to insure certain low-income individuals, including families with children, the elderly, and those with disabilities, the variation in state implementation results in a patchwork of coverage across the United States.