Final answer:
After the ACA, Medicaid expanded eligibility to more low and moderate-income individuals, though not all states adopted the expansion. The ACA also implemented an individual mandate to help fund this expansion, along with increasing taxes for high-income earners.
Step-by-step explanation:
Changes in Medicaid After the ACA
Medicaid underwent significant changes following the enactment of the Affordable Care Act (ACA), also known as Obamacare. The ACA aimed to expand healthcare coverage, including Medicaid, to more Americans by increasing the income threshold necessary for eligibility. As a result, states were offered federal funding to raise these minimum income requirements, which effectively allowed a broader range of low and moderate-income individuals to qualify for Medicaid. However, the extension of Medicaid was not universally accepted. Some states, particularly those with Republican majorities, declined to expand, citing concerns over long-term costs and state autonomy. This decision left many people without coverage that would have been available if they resided in states that accepted the expansion. The ACA also introduced the individual mandate to encourage a wider range of individuals to obtain insurance, balancing the risk pools and helping to fund the change to Medicaid. The cost implications of the ACA, including its effect on Medicaid, were complex, involving shifts in federal spending as well as new taxes like the additional Medicare tax on higher-income Americans. Noteworthy as well, under the Trump administration, there were attempts to further modify Medicaid by allowing states to implement work requirements for beneficiaries, a move that sparked considerable controversy. These efforts marked yet another change in the dynamics of how Medicaid operates, affecting the coverage and access to healthcare for millions.