What support level did the federal government provide to states that opted to expand Medicaid under the ACA?

The federal government provided substantial support to states that chose to expand Medicaid under the Affordable Care Act (ACA) by covering 100% of the costs for newly eligible enrollees for the first three years after the expansion, from 2014 to 2016. This was designed to incentivize states to participate in Medicaid expansion. After 2016, this federal support gradually decreased to a base rate of 90%.

This funding structure was significant as it aimed to reduce the financial burden on states and make it financially viable for them to expand their Medicaid programs, thereby increasing access to healthcare for low-income individuals and families. Such a high initial federal match rate was intended to encourage states to take action to extend coverage and, ultimately, to improve overall public health outcomes while reducing the number of uninsured Americans.