Medicaid - Past, Present and Future

April 2017 Enrollment Report - 69 million People Covered


Medicaid is available in all states and provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Since 1965 Medicaid has been a government insurance program that has been available for persons of all ages whose income and resources are insufficient to pay for health care. It is the largest source of funding for medical and health-related services for people with low income in the United States. It is a means-tested program that was jointly funded by the state and federal governments and managed by the states.

In all states you can qualify for Medicaid based on income, household size, disability, family status, and other factors. Eligibility rules differ between states. In 2009 approximately 50.9 million U.S. citizens were enrolled for Medicaid.

The Affordable Care Act (aka Obamacare), enacted in March 2010, expand Medicaid coverage to millions of Americans by expanding the qualifying income to 400% above the federal poverty level (FPL). Some states have expanded their Medicaid programs under ACA to cover all people with household incomes below that level. Others haven’t.

In states that have expanded Medicaid coverage under ACA, you can qualify based on your income alone. Estimates were that there would be 5 million new enrollees in Medicaid nationally. However, enrollment increased by over 11 million people, 71% of whom are able-bodied working adults. In 2015 Medicaid spending grew to $545 billion, $232 billion over the original CBO estimates.

According to April 2017 data, 74,531,002 individuals were enrolled in Medicaid and CHIP where 68,884,085 individuals were enrolled in Medicaid and 5,646,917 individuals were enrolled in CHIP. Currently, 44 million beneficiaries are enrolled in the Medicare program. Medicare is funded by every working adult through payroll taxes and enrollees pay a monthly premium and yet there are 70% more people on welfare funded Medicaid than on Medicare.

Expenditure data available for 2015 shows that the National Healthcare Expenditure (NHE) to be $3.2 trillion. The U.S. Population is currently hovering at around 320 million, so healthcare spending for that year will reach $10,000 per person.

As for the GOP's proposed changes to Medicaid, the example that would put me in favor of the changes comes unwittingly from the Kaiser Family Foundation's¹ article "How Would Proposed Changes to Medicaid and Marketplace Coverage Affect Real People?" Their story goes like this. "Without Medicaid expansion, Tracy would lose his Medicaid coverage and access to services supporting his substance use recovery. Tracy is a 38-year-old full-time student pursuing a teaching degree in Albuquerque, New Mexico." It is difficult for me to understand a tale like this.

If changes were enacted that would limit federal Medicaid funding through a per capita cap or a block grant for states that have implemented the Affordable Care Act (ACA) Medicaid Expansion and Tracy lost his Medicaid, it may seem harsh but, I would say to Tracy "You're 38 years old. Get control of yourself and get a job."

[1] Kaiser Family Foundation

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