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Today’s R&D covers Medicaid, the federal program that provides health insurance coverage for poor Americans.  As part of the Affordable Care Act states were encouraged to expand Medicaid enrollment to those Americans makes less than 138% of the Federal Poverty Level (FPL).  The original legislation threatened to strip states of Medicaid funding if they refused expansion, but the Supreme Court found this provision to be unconstitutional.  The federal government is paying 100% of the cost of Medicaid expansion until 2017 and then pays for 90% of the costs until 2022.  Twenty states have opted not to expand Medicaid, with some governors citing concerns about the state costs of expanding the program in future years.