U.S. President Barack Obama signs the Affordable Health Care for America Act during a ceremony with fellow Democrats in the East Room of the White House March 23, 2010 in Washington, DC. Win McNamee | Getty Images

Despite suffering from a past heart attack and diabetes a woman was able to receive medical coverage through Medicaid expansion under the Affordable Care Act. Luke Sharrett | The Washington Post | Getty Images

"There's a lot of people who have health problems that prevent them from working," said Linda Jordan, a public benefits lawyer at the Center for Civil Justice in Michigan. Starting in January, many Medicaid recipients in Michigan will have to show at least 80 hours a month of workforce engagement to maintain their coverage. Other states, meanwhile, have fully adopted the Affordable Care Act — and gone further to cover their residents. In 2020, California will become the first state to offer state subsidies to people who earn too much to qualify for federal tax credits on the health-care marketplace. For example, an individual earning $70,000 a year and a family of four making $150,000 could qualify for the state relief.