Honors Theses

Date of Award


Document Type

Undergraduate Thesis


Public Policy Leadership

First Advisor

Jody Holland

Relational Format



For decades, Medicaid has been the largest public health insurance program for low-income individuals in the United States. The Affordable Care Act, signed into law by President Barack Obama on March 23, 2010, significantly changed eligibility requirements for Medicaid, expanding coverage to all low-income adults at or below 138% of the Federal Poverty Level. On June 28, 2012, the Supreme Court of the United States ruled in National Federation of Independent Business v. Sebelius that the Affordable Care Act’s Medicaid expansion was unconstitutionally coercive but ruled that states remain eligible for expansion if they so choose. Thirty-seven states including Washington D.C., have expanded Medicaid eligibility under the Affordable Care Act. This research attempts to discover the benefits of Medicaid expansion through a literature review. There are mixed results regarding health outcomes. Economic outcomes are generally positive, producing net savings for state budgets and financially aiding low-income individuals to receive health insurance. Politically, the Affordable Care Act has been incredibly divisive. Democrats have generally supported Medicaid expansion, while Republicans have generally opposed it. Mississippi has not expanded Medicaid, but there is certainly a case for it. Mississippi is objectively one of the unhealthiest states in the country, and many low-income Mississippians have no realistic access to healthcare. Realistically, Mississippi will not expand Medicaid through the traditional legislative process; however, the research recommends that Mississippi could expand through a non-traditional method that is more politically feasible, such as a Section 1115 waiver.

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