Our country has elected to provide health care to our fellow countrymen in need: to seniors through the Medicare program, to the indigent through Medicaid, to needy children through the Child Health Insurance Program, and to indigent women of childbearing years through Title X. The Affordable Care Act extended this tradition by allowing states to expand Medicaid eligibility to families with income up to 1.38 times the poverty line while providing subsidies to others to enable them to purchase insurance on regulated health exchanges The actual health care is delivered by thousands of providers who are reimbursed for the care they provide through these programs.