the Affordable Care Act passed in 2010, it expanded qualification for Medicaid to 138 percent of the poverty level for all adults (about $30,000 for a family of three in 2020) and equalized eligibility rules across all states. But in 2012, a Supreme Court majority invoked states’ rights to strike down the Medicaid expansion and make it optional. Within the year, the lines were drawn in an all-too-familiar way: almost all the states of the former Confederacy refused to expand Medicaid, while most other states did.
