Multiple Medicaid Missions: Targeting, Universalism, or Both?

Medicaid began as a poverty program for the poorest of the "worthy poor." In the next five decades, it extended its reach to cover a broad population for some of its services, including, for example, about half of all childbirths in the United States, and almost half of all long-term care services. The Affordable Care Act (ACA) pushed Medicaid's breadth further, although that extension was at least delayed in many states by the Supreme Court.