Why did the Affordable Care Act expand Medicaid eligibility?

The Patient Protection and Affordable Care Act (ACA) expanded Medicaid eligibility primarily to increase access to health insurance for low-income Americans. By revising eligibility requirements to cover individuals earning less than 133 percent of the poverty level, the law aimed to add approximately 16 million new beneficiaries to the program.123

This expansion was a central component of the ACA's broader goal to extend coverage to millions of uninsured residents. While the Supreme Court later upheld the constitutionality of this expansion in the Affordable Care Act cases, it limited the federal government's ability to compel state participation by prohibiting the withholding of existing Medicaid funds from states that chose not to expand their rolls.23