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Voluntary fortification of food products with folic acid takes place in a lot of countries (in some of them also along with the mandatory one), e.g., Canada, the U.S.A., the Dominican Republic, Sierra Leone, Sudan, Eswatini, Saudi Arabia, Kuwait, Iraq, India, Bangladesh, Myanmar, China, and many European countries 458,587,612,614,642,654,660,688,694,695,696,697,698,699,700,701,702,703,704,705,706,707,708,709

In contrast, states may choose either mandatory or voluntary enrollment in Medicaid managed care programs, although they need CMS waiver approval to require mandatory enrollment of certain populations (e.g., dual eligible and children with special health care needs)

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