Medicaid
Medicaid provides health coverage for low-income children and adults, medical and long-term care coverage for people with disabilities, and assistance with health and long-term care expenses for low-income seniors. Nearly 59 million people rely on Medicaid services.
Medicaid is jointly funded by the federal government and the states. Each state administers its own program, and the federal Centers for Medicare and Medicaid Services (CMS) monitors the programs and sets quality, funding, and eligibility standards.
This section of our Web site provides resources on Medicaid laws and regulations and keeps you up-to-date on the battle to sustain and improve this important program.
Children receive health coverage through Medicaid and the State Children’s Health Insurance Program (CHIP). To learn more about CHIP, see the Children’s Health section.
The Latest
Medicaid and the Economic Recovery Package
Summary of Medicaid Provisions
- $87 billion for increased federal Medicaid matching rates through December 31, 2010;
- Every state receives a 6.2 percentage point increase in their federal Medicaid matching rate for expenditures between October 1, 2008, and December 31, 2010;
- States will also receive an additional boost in their matching rate based on their unemployment rate;
- States must maintain Medicaid eligibility and enrollment policies that were in place as of July 1, 2008, in order to qualify for the increased matching rate after July 1, 2009;
- Extends the moratoria on the following Medicaid regulations until June 30, 2009: targeted case management, provider taxes, school-based administration and transportation services. Also adds a moratorium on the hospital outpatient services Medicaid regulation through June 30, 2009, and includes a Sense of Congress that the Secretary of HHS should not promulgate regulations concerning payments to public providers, graduate medical education, and rehabilitative services;
- Extends Transitional Medical Assistance until December 31, 2010;
- Extends the Qualified Individual (QI) program (which helps certain low-income individuals pay their Medicare Part B premiums) until December 31, 2010;
- Increases funding to Disproportionate Share Hospitals (DSH) by 2.5 percentage points in FY 2009 and another 2.5 percentage points in FY 2010.
From Families USA:
Helping People with Long-Term Health Care Needs: Improving Access to Home- and Community-Based Services in Medicaid discusses how health care reform will give states incentives to strengthen home- and community-based services in Medicaid. (October 2009)
Medicaid and the Children's Health Insurance Program (CHIP) Soften the Blow during Tough Economic Times discusses how these programs have served as an effective health care safety net for many newly uninsured families, particularly for children. (October 2009)
CHIPRA: The Children's Health Insurance Program Reauthorization Act - A Series of Issue Briefs. In February 2009, after a protracted political fight, Congress enacted, and President Obama signed, legislation that renewed CHIP through the end of 2013 and expanded its scope. These issue briefs examine the new provisions that were included in the reauthorization and how they will affect implementation in the coming months.
From the Children’s Partnership and the Kaiser Commission on Medicaid and the Uninsured
Why Express Lane Eligibility Makes Sense for States and Low-Income Families explains how Express Lane Eligibility would help states streamline enrollment and renewal of children in Medicaid and CHIP by coordinating across programs. The brief highlights the potential benefits of an Express Lane Eligibility initiative, including increasing access to care for low-income children, making coverage more stable, and reducing administrative costs. (October 2009)
From the Government Accountability Office
Medicaid: State and Federal Actions Have Been Taken to Improve Children’s Access to Dental Services, but Gaps Remain discusses the different tools that states use to monitor the provision of dental services to children in Medicaid. Despite states’ efforts to improve access to dental services by increasing reimbursement rates or simplifying claims processes, access remains low. (September 2009)
From Health Affairs
Uninsured Adults with Chronic Conditions or Disabilities: Gaps in Public Insurance Programs discusses why an increasingly large number of working-age adults with low incomes and chronic health conditions or disabilities lack insurance. The brief argues that narrow eligibility requirements for Medicaid often exclude this vulnerable group. Expanding these requirements to ensure greater access to coverage should be a priority in national health reform. (October 2009) Subscription Required
Containing Costs and Improving Care for Children in Medicaid and CHIP explains that spending in both programs is highly concentrated, particularly among children with chronic health problems. The report suggests that strategies to contain costs by reducing avoidable hospitalizations among children with chronic problems and policies that increase preventive care would help both CHIP and Medicaid better serve their enrollees. (September 2009) Subscription Required
From the Kaiser Commission on Medicaid and the Uninsured
Changes in Health Insurance Coverage, 2007-2008: Early Impact of the Recession indicates that the sharp decrease in coverage over this time period (1.5 million newly uninsured adults) was largely due to declines in job-based insurance. Coverage through public programs has bridged some of this gap, but increases in coverage for children were substantially larger than for adults. (October 2009)
Medicaid Beneficiaries and Access to Care examines Medicaid’s role in providing access to health care for low-income children and adults. The brief explains that Medicaid has increased access to care, provides comprehensive and affordable coverage, and addresses the special needs of its target populations. It also notes that health reform provides a unique opportunity to expand and strengthen access through Medicaid. (October 2009)
Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts discusses the growing consensus that home- and community-based services (HCBS) are preferred among Medicaid beneficiaries with long-term care needs. It outlines some experts’ ideas on how to further the move to more HCBS by expanding Medicaid eligibility and access to HCBS, increasing funding for long-term services, and addressing workforce shortages. (September 2009)
The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession details how Medicaid funds in the American Recovery and Reinvestment Act (ARRA) helped states address budget shortfalls, preserve Medicaid eligibility, and avoid or lessen program cuts. ARRA allowed 36 states to completely avoid cuts to Medicaid benefits and either eliminate or reduce their Medicaid budget shortfalls. (September 2009)
From the Kaiser Family Foundation
Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage examines the health care needs and medical expenses of three individuals who require extensive acute and long-term care to discover how reform proposals can best serve those with special health needs. It concludes that a comprehensive benefits package, limits on out-of-pocket expenses, subsidies, and strong Medicaid programs are essential to ensuring that people with special needs are fully supported under health reform. (September 2009)
From the Robert Wood Johnson Foundation
Assuring Health Coverage for Rural People through Health Reform compares health insurance trends of rural and urban residents. Rural workers tend to have less job-based coverage and pay more than urban workers for similar plans. Several provisions in the current health reform proposals, such as providing subsidies to purchase insurance and expanding Medicaid, would significantly benefit rural consumers. (October 2009)
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