"The lifesaving effects of Medicaid expansion are significant, with a projected 39 to 64 percent reduction in yearly death rates for older persons who obtain coverage." According to a groundbreaking research, the Affordable Care Act's (ACA) extension of Medicaid to low-income individuals saves thousands of lives each year. The study, which was published in the Journal of the American Medical Association (JAMA), concluded that if all states had expanded their programs as planned, over 50,000 people would not have died in 2007-2008 alone. The researchers estimated that if all states had implemented the policy change as intended, 740,000 people would be alive today. Medicaid is government health insurance for low-income individuals and families. Before the ACA, most states opted out of the program altogether, so the only option for many poor people was to go without medical care or pay for it out of pocket. Through Medicaid, low-income adults aged 19-64 can now be covered by a state plan, including children and pregnant women. The federal government provides funding for states that choose to participate in Medicaid. In addition to extending health insurance to millions of Americans, the ACA includes incentives for states to improve their own health care systems by allowing certain types of changes to their infrastructure or programs to receive federal funds. As a result, several states have moved forward with Medicaid reforms designed to improve access to care or reduce costs.