As we mark the 10th anniversary of the first expansions of states’ Medicaid programs under the Affordable Care Act, which began in January 2014, it’s time to think again about the effects on the most vulnerable in our society. Consider, for example, what is unfolding in North Carolina. Last month, it became the 40th state to expand Medicaid under the ACA, opening the program to an estimated 600,000 adults who, while relatively low-income earners, previously did not qualify. The immediate effects deserve to be celebrated: Thousands of uninsured people are gaining coverage, including some who are coping with debilitating illnesses. Yet as new enrollees flood into the program, fewe
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