Question: Which of the following is NOT true regarding changes to Medicaid under the ACA? Group of answer choices None of the other options are correct; all of the other options are true of changes to Medicaid under the ACA. The U.S. Supreme Court held in 2012 that the federal government cannot withdraw existing Medicaid funds from states that decline to participate in the ACA's expansion of Medicaid. Some states governments have decided to expand their Medicaid programs, while other states have refused to participate in the expansion. The ACA replaces the state-federal Medicaid program with an expansion of the Medicare program, which is operated solely by the federal government.