A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage

This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. More than half of states implemented a Medicaid program within the first year federal funding became available, and nearly all states were participating in Medicaid within four years. Over time, states have met new federal requirements to extend Medicaid coverage and expanded beyond minimum coverage levels. The brief provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable Care Act.

Brief (.pdf)