How did Medicaid expansion under the ACA affect eligibility?

• A. Extended eligibility to adults with incomes up to 138% FPL in participating states.
• B. Eliminated all differences in eligibility between states.
• C. It reduced overall coverage.
• D. Only children were affected.

Answer: (A)

Expanding Medicaid under the ACA broadened who could qualify. In states that chose to participate, adults with incomes up to about 138% of the federal poverty level became eligible, extending coverage beyond the traditional groups (such as certain low‑income parents, pregnant women, and people with disabilities) to a large number of otherwise uninsured adults. This is why this option is the best answer.

Note that it didn’t eliminate differences between states, because many states did not adopt the expansion, so eligibility rules remained more restrictive in those places. It also didn’t reduce overall coverage; it generally increased coverage for adults in expansion states. And it wasn’t limited to children—adults were specifically included through the expansion.