Medicaid

A joint United States federal and state health coverage program for low-income individuals and families, enacted alongside Medicare in the Social Security Amendments of 1965. Each state administers its own Medicaid program within federal rules, setting its own eligibility thresholds and covered benefits above a federally required minimum, with the federal government matching a share of each state's spending. It is the largest single source of health coverage for low-income Americans, covering more than 80 million people by the early 2020s, including a large share of the country's nursing-home residents and children in low-income families. The Affordable Care Act's 2014 expansion extended eligibility to a broader range of low-income adults, but the Supreme Court made that expansion optional for states, and a number of states had still not adopted it as of the mid-2020s, producing significant state-to-state variation in coverage.