Medicaid

What is Medicaid?

  • Medicaid is a federal-state partnership program that aims to provide affordable health insurance to vulnerable populations in the United States.

Who funds the Medicaid program?

  • The federal government provides over half the funding for states to implement their own unique Medicaid programs. State programs must meet the minimum federal eligibility requirements to receive federal funding. States are not obligated to participate in the Medicaid program, but all 50 states currently participate.

What are the minimum federal eligibility requirements?

  • The federal government requires that certain vulnerable groups receive coverage. Groups include pregnant women, pre-school-aged children, school-aged children, elderly people, people with disabilities, and working parents. Individuals who fall into these categories may be eligible for Medicaid depending on their socio-economic status. Pregnant women and pre-school-aged children are eligible if they live at or below 133% of the federal poverty line. School-aged children are covered at or below 100%, people who are elderly or have disabilities are covered at or below 75%, and working parents are covered at or below 28% of the poverty line. See the two charts below for a visualĀ representationĀ of Medicaid eligibility and for the federal poverty line guidelines.

 

Can states cover more than the minimum federal eligibility requirements?

  • Yes. States have the option to increase the funding for all vulnerable groups and also childless adults. States that opt to expand their Medicaid programs receive the same rate of federal funding for the expansions.

What medical services does Medicaid cover?

  • Just as with eligibility levels, the federal government requires that states’ Medicaid plans cover certain basic services. The federal government also provides a list of optional services states can provide, as seen in the chart below