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
Breaking News:
HHS announced on February 18, 2010, that the ARRA increased federal Medicaid share applies to the Part D clawback payments that states make to the federal government, as well as other services. That has not been the case up until now, but it will be effective retroactively to October 2008. According to HHS, this amounts to about $4.3 billion in savings for states over the 27-month period of October 2008-December 2010. This is good news for states, and for Medicaid.
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:
Expanding Coverage for Recent Immigrants: CHIPRA Gives States New Options examines the provision that lifts the "five year bar" for legally residing immigrant children and pregnant women. It discusses how states can take advantage of this new option to expand coverage—and why they should. (March 2010)
Improving Language Access: CHIPRA Provides Increased Funding for Language Services discusses the increased funding for language assistance services (interpretation and translation) and how states cover these services for Medicaid and CHIP enrollees who are limited English proficient, or LEP. (February 2010)
States in Need: Congress Should Extend Temporary Increase in Medicaid Funding examines why states continue to need this federal help. It includes state-specific data on the federal Medicaid support in the President's budget and on the many positive economic impacts of extending this fiscal relief. (February 2010)
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.
Establishing a Consumer Health Assistance Program in Your Community: Consumer health assistance programs provide valuable services to people who have questions about health insurance (such as Medicaid or private insurance) or who are having trouble getting access to health care. For information on establishing such a program in your community, click here.
From the Kaiser Commission on Medicaid and the Uninsured
Medicaid and Managed Care: Key Data, Trends, and Issues discusses a variety of issues, including enrollment, access, and quality of care. Medicaid managed care is supposed to support an approach to practice that emphasizes early identification of health issues and coordinated care. This brief examines current data to see how well Medicaid managed care programs have done in achieving these goals. (February 2010)
Medicaid Enrollment: June 2009 Data Snapshot looks at the changes in Medicaid enrollment over the past 10 years (2000-2009). The brief provides both national and state-level data on monthly and yearly enrollment, as well as changes in enrollment over the decade. Both the national and state-level data show that Medicaid enrollment has consistently increased throughout the recession. (February 2010)
Medicaid’s Continuing Crunch in a Recession: A Mid-Year Update for State FY 2010 and Preview for FY 2011 reports on interviews with Medicaid directors from all 50 states and the District of Columbia about several issues, including the effects of the recession. Their primary concern is the upcoming end of the enhanced federal Medicaid match (as provided in the stimulus act) and what that will mean for state budgets. (February 2010)
Medicaid Home and Community-Based Services Programs: Data Update discusses the development of home- and community-based service (HCBS) alternatives to institutional care in state Medicaid programs. While the majority of funding for long-term care in Medicaid still goes toward institutional care, the percentage of total Medicaid spending on HCBS has more than doubled in the past 15 years. (November 2009)
From the Kaiser Family Foundation
Racial/Ethnic Disparities in Access to Care among Children: How Does Medicaid Do in Closing the Gaps? examines how disparities among children in Medicaid compare with those among privately insured and uninsured children. The findings reveal that disparities in Medicaid were similar to those in the private insurance market, and although the majority of children fare well in terms of access, problems still persist for children trying to get access to the health care they need. (December 2009)
From the Kaiser Family Foundation and George Washington University Medical Center School of Public Health and Health Services
State Medicaid Coverage of Family Planning Services: Summary of State Survey Findings reports that there is great variation from state to state in what is covered under their family planning benefits. Some benefits include vaccinations, contraception, and screenings and treatment for sexually transmitted diseases and cancer, in addition to services that enable women to prevent unintended pregnancies, space pregnancies, and plan their family size. (November 2009)
From the Robert Wood Johnson Foundation and the Urban Institute
Progress Enrolling Children in Medicaid/CHIP: Who Is Left and What Are the Prospects for Covering More Children? notes that improving enrollment and retention processes and tailoring outreach strategies to uninsured children and their communities are crucial. The Medicaid expansion under health reform will also help increase enrollment, but continuing existing efforts will be key to preventing gaps in coverage. (November 2009)
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