State rules on who qualifies for Medicaid vary widely. The Affordable Care Act would bring all states up to the same standard: Everyone with incomes at 133 percent of the federal poverty level would receive coverage. But the Supreme Court ruled that states can’t be penalized if they don’t go along with the expansion. In states that opt out, poor people who would otherwise have been newly eligible for Medicaid would not receive it. Still, because of a quirk in the law, the most well-off of these people — those with incomes between the federal poverty level and 133 percent of that level — would become eligible for an alternative: federal subsidies to buy private insurance plans in state-based marketplaces, or exchanges, created by the law. Read related article.