"One of the key provisions of the Affordable Care Act was to expand Medicaid to nearly all people under age 65 who have incomes of less than 138 percent of the federal poverty level."

Original Medicaid was intended to provide health free health insurance to indigents.  ACA, Obamacare, expanded it to include the above.

Is this what we wanted?  We now have a situation where taxpayers are subsidizing a new group of people who have incomes of less than 138 percent of the federal poverty level.  The current federal poverty level in Hawaii for one person is $20,783 (138%).  It increases as the number of people in the family increases.