More ABC US news | ABC Health NewsCopy

Health care may seem like it's faded into the background this midterm election cycle, but there is actually a lot at stake for many aspects of Obamacare.

In particular, the future of Medicaid expansion may be altered depending on which way the votes go.

Heres a guide to what could change and why it matters:

First, an Explanation

Medicaid is a federally funded program that provides health care to low-income Americans. The Affordable Care Act expanded the program to cover more people, but a ruling by the Supreme Court allowed states to choose whether or not to implement that provision. To date, 23 states -- mostly conservative and Republican-controlled -- have elected not to expand.

Why Not Expand?

The main argument against expansion is that its too expensive and the federal government cant continue supporting it long-term, said Scott Brunner, a senior analyst with the Kansas Health Institute and a former Kansas state Medicaid director.

Many non-expansion states want to focus on improving quality of care before offering it to more people, he added.

Those in favor of expansion believe it would provide health care to hundreds of thousands more people who currently cant afford it, Brunner said, adding that a larger program might also stimulate the economy by creating health care-related jobs.

More:

Why Today's Election May Affect Your Health Care