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The history of Medicaid is a testament to the efforts by the US government to provide heath care to people with low income. Medicaid is a government program that is managed by each state to meet the needs of their poorer communities. Eligibility is determined based on a set of financial and employment related criteria that varies by state, and is focused on children, seniors, people with disabilities and low income parents.
In 1965, Medicaid was created through the Social Security Act. Federal centers for Medicare and Medicaid services are responsible for monitoring how each state runs their individual programs. They are also responsible for defining and measuring the quality of service, method of delivery, level of funding and the eligibility criteria that is established by each state. In 1967 the early and periodic screening, diagnostic, and treatment (EPSDT) comprehensive plan was developed for all children under the age of 21.
Freedom of choice, home, and community based care waivers were created in 1981. These waivers increased the flexibility of participants to select their own care provider. That same year, all states were required to pay hospitals that were providing health care services to a larger share of low income patients with additional funding to support their services. This change was designed to reduce the financial incentive for hospitals to limit the number of low income patients being treated. Adjustments like this ensured that the intent of the program was maintained throughout the history of Medicaid.
Although it was formed in 1965, Medicaid was not available in every state until 1982. The history of Medicaid shows a conflict within each state on the role of government and health care. In the United States, health care is a commodity purchased and paid for at the individual or employer level. The amount of government involvement in the Medicaid program varies by state. Some states administer the entire program, with a short list of approve doctors, health care providers and other states have outsourced the management of the entire program to private firms.
Dental services were added to Medicaid in 1989, when the United States Congress determined that all states must provide all Medicaid services to children less than 21 years of age. The types of dental services covered by Medicaid vary by state, but all are required to provide a minimal of pain relief, teeth restoration and to ensure the maintenance of dental health standards. There are several programs are designed to provide a method for early diagnosis and treatment of standard medical conditions. An important benefit of Medicaid is the provision that the state is responsible for providing treatment for any disease identified during oral screening. This is true even if that illness is not covered under the patient’s current Medicaid plan.
On 1 January 1991, the Medicaid Drug Rebate Program was launched. The Omnibus Reconciliation Act of 1990 initially created the program. The purpose of program is to create a mechanism for managing the cost of prescription drugs. The program allows states to manage a master list of the drugs covered, generic substitutes, and alternative treatment options. The focus on maintaining a standard level of care for low income citizens remains consistent throughout the history of Medicaid.
Frequently Asked Questions
What is Medicaid and when was it established?
Medicaid is a joint federal and state program that provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. It was established on July 30, 1965, when President Lyndon B. Johnson signed the Social Security Amendments into law, creating both Medicaid and Medicare as part of his Great Society program.
How has Medicaid expanded since its inception?
Since its inception, Medicaid has undergone significant expansion and reform. Notably, the Affordable Care Act (ACA) of 2010 allowed states to expand Medicaid eligibility to nearly all low-income individuals under the age of 65 with incomes up to 138% of the federal poverty level. According to the Kaiser Family Foundation, as of January 2021, 39 states including the District of Columbia have adopted the Medicaid expansion.
What populations are served by Medicaid?
Medicaid serves a diverse range of populations. Initially focused on low-income families with dependent children and individuals receiving cash assistance, it now covers various groups. These include children, pregnant women, parents, seniors, and individuals with disabilities. The program also provides funding for long-term care services, which are not typically covered by Medicare or private insurance.
How is Medicaid funded and administered?
Medicaid is funded jointly by the federal government and the individual states. The federal government matches state spending on Medicaid services based on a formula that varies by state, known as the Federal Medical Assistance Percentage (FMAP). Each state administers its own Medicaid program within broad federal guidelines, allowing for variability in coverage, eligibility, and benefits across states.
What are some key legislative changes that have shaped Medicaid?
Key legislative changes that have shaped Medicaid include the Omnibus Budget Reconciliation Acts of the 1980s and 1990s, which expanded eligibility and established the Children's Health Insurance Program (CHIP). The Balanced Budget Act of 1997 introduced the State Children's Health Insurance Program (SCHIP), now known as CHIP, which further expanded coverage for children. The ACA in 2010 was another major milestone, significantly broadening the scope of Medicaid to cover more low-income adults.