Gavel on American flag with stethoscope With Democrats controlling both chambers of Congress and the White House, health experts say this could be the only time a fix to the "Medicaid gap" will be possible for many years.

Hours after the Supreme Court in 2012 narrowly upheld the Affordable Care Act but rejected making Medicaid expansion mandatory for states, Obama administration officials laughed when asked whether that would pose a problem.

In a White House briefing, top advisers to President Barack Obama told reporters states would be foolish to turn away billions in federal funding to help residents lacking the security of health insurance.

Flash-forward nearly a decade, and it's clear to see the consequences of that ruling.

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