As Trump returns to the presidency and Republicans control Congress in 2025, Medicaid expansion under the Affordable Care Act faces significant threats. Over 3 million adults in nine states could lose coverage if federal funding is reduced. Trigger laws in these states would terminate Medicaid expansion swiftly, jeopardizing health coverage for many low-income individuals. Policymakers are concerned that rollbacks on Medicaid could lead to increased uninsured rates, creating barriers to care, as states consider the impact of budget constraints and shifting political climates.