In the 51 years since President Lyndon B. Johnson signed it into law, Medicaid has brought our country much closer to affordable healthcare for all Americans.

Medicaid Turns 51: The Program’s Past, Present, and Future

In the 51 years since President Lyndon B. Johnson signed it into law, Medicaid has brought our country much closer to affordable healthcare for all Americans.

Born on July 30 in 1965, the federal program has been instrumental in building Johnson’s Great Society” and has proved to be an invaluable weapon against poverty and disease.

As of this May, a record-breaking 72.5 million Americans benefited from the healthcare program — an increase of 15 million since October 2013, when the federal insurance marketplace’s initial enrollment began.

But for all its success, Medicaid’s work is not done. Years after the Affordable Care Act’s passage, there are still millions of Americans caught in coverage gaps who lack health insurance. A nationwide Medicaid expansion, which has currently reached just 31 states, holds the key to the universal coverage the ACA’s drafters had in mind.

Medicaid Milestone: Expansion Under the ACA

In its five-decade life, the greatest — and most recent — major change to Medicaid has been its expansion through the ACA. Signed into law in 2010, the healthcare bill made serious headway in improving healthcare for children, low-income parents, pregnant women, people with disabilities, and the elderly.

More specifically, the ACA has already made healthcare accessible to 31 million children and their 11 million low-income parents. It’s also brought 8.8 million citizens with disabilities under its wing, many of whom are burdened by lifelong healthcare expenses. As more states embrace expansion, Medicaid will continue to level the playing field for working Americans, regardless of income levels or preexisting conditions.

Today’s Prescription for Health and Savings

Medicaid indirectly combats stagnant wages and rising healthcare costs, two ongoing issues that have impoverished millions of Americans.

Medicaid is beginning to make an impact in expansion states such as Louisiana, where the newly elected governor made expansion a priority, helping to deliver coverage to hundreds of thousands of people who desperately needed it.

In Georgia, expansion’s impact could dwarf even that of Louisiana. Should it choose to expand during the next legislative session, Medicaid could provide 853,000 Georgia residents with insurance that’s proven to decrease out-of-pocket medical spending from $871 to $376 per beneficiary.

The longer states wait to expand, the more rural citizens and healthcare facilities suffer. The 19 states blocking expansion saw 52 rural hospitals close their doors since the ACA’s passage — 77 percent of all rural closures during that period.

The reason for so many closures? Hospitals can’t, by law, turn uninsured patients away for emergency care, but they’re often stuck with the bill when patients can’t pay. Louisiana, which recently adopted expansion, is projecting charity care savings of $677 million — a big bump for its ailing budget.

Considering that state budgets have been repeatedly slashed since the Great Recession, Medicaid’s financial perks haven’t gone unnoticed. The healthcare industry in expansion states has grown by a year-on-year average of 2.4 percent, compared to 1.8 percent in nonadoptive states. Kentucky saw an economic boom of $30 billion following expansion, while Ohio’s expansion created nearly 32,000 new jobs.

Benchmarks for a Better Medicaid

Medicaid has an impressive history and a vibrant present, but what about its future?

State-by-state expansion will continue as today’s non-expansion states model their programs after recent success stories.

In the coming years, we’ll likely see Medicaid make further inroads in the South. Louisiana’s expansion is already spurring conversations in Georgia and Florida.

We’ll likely also see expansion sweep other holdouts such as Utah, where Republican legislators oppose the program. Its citizens are clamoring for expansion, though, and Utah’s government will likely yield to political pressures and expand Medicaid. Such an adoption would cover more than 9,000 low-income Utahns.

There’s no way to predict exactly how Medicaid will change or which states will be the next to adopt, but one thing is sure: In the next 51 years, Medicaid’s value to states, families, and businesses will only grow.