What is Medicaid

Medicaid is a health care program that assists low-income families or individuals in paying for doctor visits, hospital stays, long-term medical, custodial care costs and more. Medicaid is a joint program, funded primarily by the federal government and run at the state level, where coverage may vary. Medicaid is available only to individuals and families who meet specified criteria. Recipients must be legal permanent residents or citizens of the United States, and may include low-income adults, their dependents and people with specified disabilities.

BREAKING DOWN Medicaid

Medicaid is a government-sponsored insurance program for individuals of any age whose resources and income are insufficient to cover healthcare. In the United States, it is the largest source of funding for health-related services for low-income people. Funded jointly by state and federal governments, but mainly by the latter, Medicaid is managed at the state level. The program was authorized by the Title XIX of the Social Security Act, which also created Medicare. The bill was signed into law in 1965 by President Lyndon B. Johnson.

Every state has significant leeway in determining who is eligible for the program, as well as the right not to participate in the program. In early January, Reuters reported that the Trump administration is allowing U.S. states to move toward "imposing work or job training requirements on people as a condition for obtaining health insurance under the Medicaid government program for the poor." These requirements have not been imposed before. 

It is possible to determine eligibility for Medicaid in one of two ways. One way is to fill out an online application through the Health Insurance Marketplace website. An alternative way to apply is directly through a state’s Medicaid agency—contact information is available through Healthcare.gov.

Once a person is deemed eligible for Medicaid, he or she may receive free healthcare and related services from any medical provider that accepts the program.

Medicaid & the Patient Protection and Affordable Care Act (PPACA)

Most often referred to as the Affordable Care Act (ACA) and colloquially deemed “Obamacare,” this statute was signed into law by President Barack Obama in 2010. The law states that all legal residents and citizens of the United States with incomes up to 133% of the poverty line qualify for coverage in Medicaid-participating states. While the law has 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.

As of May 2018, according to the Henry J. Kaiser Family Foundation, the District of Columbia and 33 states had expanded Medicaid. They are: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia. There are also four states considering expansion: Idaho, Utah, Nebraska and Virginia.

The remaining 18 states, as of 2017, have chosen not to participate in the Medicaid expansion.