The Upshot: How Medicaid Works Under the Affordable Care Act

With open enrollment under the Affordable Care Act (ACA) now underway, the question of whether the nation’ssystem can equitably provide access to quality, affordable care has never been more pressing. This issue of The Upshot examines what’s happening to the country’s most popular and essential coverage—Medicaid—as it grapples with new challenges, including a recent and dramatic drop in the number of employers offering it as a benefit.

Medicaid has transformed the lives of tens of millions of low-income Americans. Its coverage has reduced infant mortality, led to sharp drops in infectious diseases like influenza and pneumonia, and helped many families get back on their feet after losing a job or a loved one.

States that have adopted the ACA’s Medicaid expansion have seen large drops in uninsured residents, reaped budget savings from lower payments to hospitals for uncompensated care, and developed innovative ways to help people with mental illness return to work and secure stable housing. Across the country, Medicaid is also helping shift the delivery of long-term services and supports for people with disabilities and seniors from costly institutional settings to home and community-based options that can better support their independence and wellbeing. During this moment of turmoil, our “Medicaid Works” series aims to inform the national debate about the future of health reform and the role of Medicaid.assurance santé