Thanks to the Affordable Care Act (ACA), low-income Americans (those earning less than 139% of the federal poverty level) living in 25 states and the District of Columbia gained eligibility to Medicaid on January 1, 2014.1 The Congressional Budget Office estimates that by 2022 there will be 12 million new enrollees into Medicaid.2 Although this is an unprecedented leap forward in providing low-income Americans with health insurance, it is important to remember that health insurance is not health care. Health insurance is a financial mechanism for paying for health care. It is not the care itself, or even a guarantee of care.