This video from Vox looks at the Medicaid system through the eyes of an individual on Medicaid, Matthew, who has Crohn’s Disease. He is one of the 1 in 5 Americans who get their healthcare paid for by Medicaid.

The video states “The thing about Matthew is, if he lived in a different state, he might not have Medicaid.” It explains the history of healthcare in the United States, the attempts of certain presidents (FDR, Truman, and LBJ) to create a national healthcare system, the reason behind the emergence of a private healthcare market, and the ultimate expansion of Medicaid under the Affordable Care Act.

Due to the Supreme Court decision that made this expansion voluntary by state, the video explains that the specific states get to decide who gets covered and what service gets covered. Some individuals are consistently covered across the board, like children and Pregnant women; However, coverage of other groups like individual who make below a certain amount per year are only covered in certain states.

The video goes on to describe the rising costs of Medicaid, due to the rising costs of health care in the United States, and ways that Republicans have proposed to change Medicaid.