Medicaid covers the neediest Americans by providing them assistance with healthcare costs.
However, individual states determine who is eligible for coverage. Alabama only gives access to those below the federal poverty line.
"You have to be way down the economic totem pole in Alabama, in order for Alabama to let you qualify for Medicaid," said Dr. Jess Brown, WHNT News 19 Political Analyst.
Dr. Brown explains that the federal government currently gives the state about $2 for every $1 the state contributes.
But if Alabama will increase the number of people eligible for Medicaid, the government will pay all of the cost for three years. After that, they'll give Alabama $9 for every one it kicks in.
Still, it's a big addition.
"Some people say it would add as many as half a million people to the Alabama Medicaid rolls, and the most conservative number I've seen is a third of a million," said Dr. Brown. "When you get to thinking about it, that starts to border on about eight percent of the entire population of the state, counting every man, woman, and child."
Dr. Brown points out Governor Robert Bentley continues to say the state will forego increased federal funds to avoid increasing its rolls.
But with President Obama being re-elected, the Affordable Care Act will get carried out for four years at a bare minimum.
That said, Dr. Brown leaves the state with a practical question.
"Alabamians are going to continue to pay federal income taxes that help fund the lion's share of Medicaid," said Dr. Brown. "Do we want to get this money back, or do we want to send it to other states? Because trust me, most other states are going to take the money."