One of the primary provisions of the Affordable Care Act gives states the options to expand their Medicaid eligibility to include individuals below 138 percent of the federal poverty level ($17,609 per year for one person or $36,233 for a family of four in 2020). The costs of expansion were paid for in full by the federal government through 2016, before dropping down (and freezing at) 90 percent in 2020, well above the typical federal match rate.
Until 2020, Oklahoma’s Governor and Legislature opted not to expand Medicaid, a decision that left billions in federal funding on the table, and more than 100,000 Oklahomans in a ‘coverage crater’ (too low-income to qualify for subsidies on the health insurance marketplace, too wealthy or not a member of a population group that is eligible to qualify for traditional Medicaid). In June 2020, Oklahoma voters narrowly approved an initiative petition, State Question 802, that will expand Medicaid no later than July 1, 2021.
As of November 2020, 39 states, including Washington D.C., have expanded Medicaid.