U.S. hospitals want to know what's going on with Medicaid. The American Hospital Association has asked Kathleen Sebelius, secretary of the Department of Health and Human Services, for clarification on Medicaid expansion. Expansion of state Medicaid programs, which cover low-income and disabled residents, is a provision of health care reform. But the U.S. Supreme Court on June 28 ruled that states aren’t required to change their Medicaid programs. Through a combination of Medicaid and a series of state health exchanges, the Affordable Care Act is designed to provide coverage for an additional 32 million Americans.