Following implementation of Medicaid expansion under the Affordable Care Act (ACA) in North Carolina and South Dakota in 2023, there has been a recent surge in expansion activity early in 2024 among several of the ten states that have not yet adopted Medicaid expansion. While activity in Alabama, Georgia, and Kansas may have stalled, there continues to be growing potential for action in Mississippi. While expansion activity is ongoing in several states, President Biden continues to urge Congress to close the coverage gap in the remaining non-expansion states, though that is unlikely in a divided Congress. This policy watch takes a look at recent activity, what expansion could mean in Mississippi, and what to watch as things continue to play out.