Medicaid is the nation's largest health insurance program, providing health and long-term care services to approximately 59 million low-income pregnant women, children, individuals with disabilities and seniors. It is a vital health care safety net and provides important services to those who cannot obtain care from any other source. Medicaid coverage also is critical for reducing the number of the uninsured, currently estimated at more than 45 million nationwide.

Authorized under Title XIX of the Social Security Act, Medicaid is a means-tested entitlement program financed by state and federal governments and administered by the states. Within national guidelines established by the federal government, each state establishes its own eligibility standards; determines the type, amount, duration and scope of services; and administers its own program.

Health Reform
On March 23, 2010, the Patient Protection and Affordable Care Act (P.L. 111-148) was signed into law. Among other changes, the new law increases the mandatory minimum income eligibility level for Medicaid to 133 percent of the federal poverty level and provides standard 5 percent income disregard for most individuals beginning January 1, 2014. States will receive additional federal funding for services delivered to the expansion population. It is estimated that the changes made by the law will result in 16 million additional individuals enrolling in the Medicaid program.

State Budgets
Medicaid spending for fiscal year 2009 was $335 billion, which was an increase of 7.8 percent over the previous year. Enrollment increased 5.4 percent in fiscal year 2009 and is projected to grow 6.6 percent in fiscal 2010. Additionally, 3.3 million more people were enrolled in Medicaid in June 2009 compared to the previous year, the largest one-year increase, according to the Kaiser Commission on Medicaid and the Uninsured.

The American Recovery and Reinvestment Act, ARRA, (P.L. 111-5) included enhanced federal funding for the Medicaid program. The money is provided to eligible states through an increase in the Federal Medical Assistance Percentage (FMAP) formula – the formula that generally determines the federal share of Medicaid expenditures. The enhanced FMAP is available for 27 months, between October 1, 2008 and December 31, 2010.

Testimony:

  • June 11, 2009 Testimony  by NGA Executive Director Ray Scheppach before the Senate Committee on Health, Education, Labor and Pensions on health care reform

  • May 5, 2009 Testimony by NGA Executive Director Ray Scheppach before the Senate Finance Committee hearing entitled "Roundtable to Discuss Health Care Reform Coverage"

  • March 25, 2009 Testimony by NGA Executive Director Ray Scheppach before the Subcommittee on Health of the Senate Finance Committee on "The Role of Long Term Care in Health Reform"

  • March 27, 2007 Testimony by NGA Executive Director Ray Scheppach before the House Energy and Commerce Subcommittee on Health on "Insuring Bright Futures: Improving Access to Dental Care and Providing a Healthy Start for Children"

Resources