Final answer:
In 2009, before the expansion of Medicaid under the Affordable Care Act, only five states expanded health coverage options under Medicaid. Medicaid is a federal-state program providing insurance to low-income Americans and varies by state. The expansion aimed to include more people under the federal poverty level.
Step-by-step explanation:
In 2009, only 5 states opted to expand certain health coverage options under Medicaid. Congress established Medicaid in 1965, aiming to provide medical insurance to various low-income individuals, including families with children, the elderly, the disabled, and those living below the poverty line. Each state administers Medicaid and determines the level of benefits and eligibility, leading to variability in coverage across the country. In some states, standards and benefits may be more comprehensive, while in others, they might be more limited.
By 2009, the disparities in state Medicaid programs were evident. This was before the Affordable Care Act injected significant reforms into the system, aiming to standardize and expand coverage. Prior to the expansion, many states had not broadened their Medicaid eligibility to cover all individuals under the poverty line, leaving many without coverage. The expansion was designed to change this by including more of the poorest Americans, including able-bodied adults under 65 who earn no more than 133 percent of the federal poverty level.