Imagine that you are a health policy analyst for a state that has not elected to expand Medicaid as part of the Affordable Care Act (ACA). You have just been notified that the state leaders have agreed to reconsider their decision during an upcoming session. Go to the Kaiser Family Foundation Website, at www.kff.org, and The Commonwealth Fund website, at http://www.commonwealthfund.org/publications/blog/2014/mar/medicaid-expansion-alternative-state-approaches, for additional information on Medicaid expansion.
Write a three to four (3-4) page paper in which you:
1. Identify a state that has not elected to participate in the Medicaid expansion initiative under the Affordable Care Act. Critically analyze the implications of the state’s decision to opt out of Medicaid expansion on the citizens of the state.
2. Compare the potential opportunities and challenges of a state’s decision to opt into the Medicaid expansion.
3. Explore two (2) alternate approaches to expanding access to care that have been implemented or considered by states opting out of Medicaid expansion. Compare and contrast the two (2) alternate approaches to the Medicaid expansion initiative.
4. Provide a recommendation to the state legislature on whether or not the state should opt in to the Medicaid expansion. Provide a rationale for your recommendation.
5. Use at least three (3) recent (within the last five  years), quality academic resources in this assignment. Note: Wikipedia and other Websites do not qualify as academic resources.
Your assignment must follow these formatting requirements:
· Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
· Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:
· Develop policies that ensure compliance of healthcare delivery systems with current legislation.
· Apply decision-making models to address difficult management situations.
· Use technology and information resources to research issues in Health Care Operations Management.
· Write clearly and concisely about Health Care Operations Management using proper writing mechanics.