Senior Research Analyst
Medicaid turns 50 on July 30. We’re kicking off a blog series to recognize how this program has transformed health care for low-income families and individuals, including children, parents, pregnant mothers, seniors, and people with disabilities.
President Harry Truman envisioned Medicaid as the “protection or security against the economic effects of sickness.” Over the course of 2014, Medicaid provided health coverage for 80 million low-income Americans, as we explain in our updated backgrounder.
Medicaid covers certain services that the federal government has deemed “mandatory,” including physician, midwife, and certified nurse practitioner services; hospital services; laboratory and x-ray services; and nursing facility and home health care for adults over age 21. States can — and all do — cover additional services as well, such as prescription drugs, dental care, vision services, hearing aids, and personal care services for the frail elderly and people with disabilities.
Medicaid is important to improving low-income families and children’s well-being. Studies show that Medicaid has helped make millions of Americans healthier by improving access to preventative and primary care and by protecting against (and providing care for) serious diseases (see chart).
Medicaid plays an even more integral role in insuring low-income Americans now that health reform has been fully implemented. States have the option under health reform to expand Medicaid eligibility to non-disabled adults without children up to 138 percent of the poverty line. While 28 states and the District of Columbia have opted to expand Medicaid, eligibility levels remain low in the remaining states. In the typical non-expansion state, Medicaid eligibility is limited to working parents with incomes at 46 percent of the poverty line and isn’t available at any income level to non-disabled adults without children.
Expansion is a very good financial deal for states. The federal government will pay nearly all of the expansion costs — 95 percent over the coming ten years — the Congressional Budget Office (CBO) estimates. And, the federal government will pick up 100 percent of the cost of expansion to newly eligible individuals for the first three years and no less than 90 percent of the cost on a permanent basis.
By 2020, 14 million more adults and children will enroll in Medicaid and gain access to affordable health coverage in expansion states. If all states adopt the Medicaid expansion, however, significantly more low-income people will enroll in Medicaid, according to CBO.
As Medicaid approaches its 50th birthday, it’s providing access to health care services for millions of Americans, and its coverage expansions under health reform have helped cut the number of uninsured substantially. Yet, there’s still work to be done to ensure that Medicaid’s success reaches those in states that haven’t expanded to cover more of their low-income residents.
As Medicaid turns 50, learn more about how it improves access to health care, its long-term benefits, and why states should expand Medicaid: www.cbpp.org/medicaid-at-50