what is medicaid 
the term medicaid refers to a public health insurance program that provides health care coverage to low income families and individuals in the united states the program is jointly funded by the federal government and individual states it is operated at the state level which means that coverage and administration vary greatly from state to state it is available only to individuals and families who meet specific income based criteria recipients are u s citizens permanent residents or legal immigrants approximately 70 6 million people were covered by medicaid as of september 2020 1understanding medicaidmedicaid was signed into law in 1965 by president lyndon b johnson and authorized by title xix of the social security act which also created medicare 2 it is a government sponsored insurance program for individuals of any age whose resources and income are insufficient to cover health care medicaid does not provide health care directly to individuals instead it covers their doctor visits hospital stays long term medical care custodial care and other health related costs individual states decide on who qualifies for coverage the type of coverage and the process of paying health care workers and hospitals that s because each state is responsible to manage and administer its own medicaid program the federal government matches state spending and the matching rate varies by state from about a statutory minimum of 50 to a maximum of 83 states are not required to participate in medicaid although all states do 3 the program is the largest source of funding for health related services for low income individuals in the u s total medicaid spending came to 613 5 billion in 2019 accounting for 16 of the nation s health care bill 4 the federal government paid 64 5 of the tab while individual states paid 35 6 5 medicaid coverage has typically included the following groups eligibility was expanded to include adults under the age of 65 provided their incomes fell under 133 of the federal poverty level fpl as per the patient protection and affordable care act 7 children account for 38 of enrollees with about 18 of the total cost by comparison people with disabilities account for 14 of enrollees with about 36 of total costs 8 special conditionseligibility for medicaid is determined by filling out an application through the health insurance marketplace website or directly through your state s medicaid agency your eligibility is determined by income in relation to the fpl the fpl is used to determine whether a family or individual s income allows them to qualify for federal benefits in general if an individual s income is less than 100 to 200 of the fpl and they are either disabled a child pregnant or elderly there will be a program available for them if their income is less than 138 of the fpl then there may be a program available for them 9 the income taken into consideration in determining eligibility is an individual s modified adjusted gross income magi this is taxable income plus certain deductions such as social security benefits and tax exempt interest make sure you check the medicaid website for any changes to eligibility and other up to date information about the program the trump administration allowed u s states to remove medicaid coverage for individuals who do not meet certain work requirements or who are not engaged in work activities for a specific number of hours each month 10 arkansas was the first state to implement this policy and it resulted in 18 000 people losing health care coverage however this policy was repeatedly blocked in federal courts and arkansas has suspended the requirements 11 12 medicaid vs the patient protection and affordable care act ppaca president barack obama signed the affordable care act aca into law in 2010 13 the law referred to as obamacare states that all legal residents and citizens of the united states with incomes of up to 138 of the poverty line qualify for coverage in medicaid participating states 9 while the law worked to expand both federal funding and eligibility for medicaid the u s supreme court ruled that states are not required to participate in the expansion in order to continue receiving already established levels of medicaid funding 14as of march 2021 the following 12 states did not expand coverage alabama florida georgia kansas mississippi north carolina south carolina south dakota tennessee texas wisconsin and wyoming 15advantages of medicaidmedicaid has helped to reduce the number of people without health insurance and the aca has helped even further in 2013 the year before major provisions of the aca went into effect an estimated 44 million people didn t have health insurance by 2017 that number dropped down to 27 4 million 16many americans would be without health insurance if medicaid didn t exist this is so because low income individuals often don t have access to insurance through their jobs and purchasing private health insurance in the marketplace is simply not affordable medicaid has provided access to health care that has statistically shown improvements in the overall well being of individuals who otherwise would not be covered for even simple doctor visits or medication 