April 30, 2014 4:07 AM

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Blumenthal was specifically referring to the ACA's provision allowing individual states to expand their Medicaid eligibility standards to include nearly all poor adults. About half of the states have expanded Medicaid, with the federal government picking up the tab for the newly eligible for three years, and 90 percent of the costs thereafter.

"Notably, 16 of the states at the bottom half of the scorecard have not yet decided whether to participate in Medicaid expansion," said Cathy Schoen, a Commonwealth Fund senior vice president, and a co-author of the scorecard research.

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