This Essay begins to explore how Medicaid, after the Patient Protection and Affordable Care Act, metamorphoses from exclusion and limitations in access and benefits to a form of social insurance that implicates theories of social justice. The social justice aspect of universality provides an important lens for understanding these numbers, both in terms of the states that are expanding and the states that are opting out. States that refuse to expand their Medicaid programs are denying millions of Americans the benefit of a precious legal entitlement. It is essential that the states understand the power—and the potential—of this evolving social program and its newfound status as a vehicle of social insurance.

Document Type


Publication Date

Spring 2015

Notes/Citation Information

Nicole Huberfeld & Jessica L. Roberts, An Empirical Perspective on Medicaid as Social Insurance, 46 U. Toledo L. Rev. 545 (2015).