Medicaid is the nation's largest health program in terms of number of recipients, serving 56 million to Medicare's 48 million.
Enacted in 1964 under Title XIX of the Social Security Act, Medicaid provides medical services to low-income people and the disabled.
According to the Congressional Budget Office, in the 2010 fiscal year, 77 percent of people enrolled in Medicaid were children and families, while 23 percent were elderly or disabled. But 64 percent of Medicaid spending was for older Americans and people with disabilities, while 36 percent went to children and families.
According to the Kaiser Family Foundation, which analyzes health care issues, 7 of 10 nursing home residents are on Medicaid, in large part because even middle-class patients often run through their savings while in a nursing home and turn to the entitlement program.
In 2011, Medicaid, along with Medicare, became a central focus of the partisan debate over the nation's long-term budget. Although Medicaid provides health insurance to one in five Americans at some point in a year, it is more vulnerable to cuts than Medicare and Social Security, which have broader political support.
The Republican-controlled House passed a budget written by Representative Paul D. Ryan of Wisconsin, the House budget chairman, that would turn Medicaid, which provides health coverage for the poor through a combination of federal and state money, into a block grant program for states. The federal government would give lump sums to states, which in turn would be given more flexibility and independence over use of the money, though the plan does not spell out what the federal requirements would be.
The budget plan failed in the Democratic-controlled Senate.
In July, President Obama offered to put Medicaid, along with Social Security and Medicare, on the table in negotiations over a long-term deficit-reduction plan. The idea alarmed some Democrats, but Republicans backed away from the idea of a sweeping deal because of Mr. Obama's insistence that spending cuts be coupled with revenue increases.
In September, Mr. Obama's proposal to the special Congressional deficit-reduction committee called for shaving $72 billion from Medicaid and other health programs over the next 10 years, far less than the $248 billion reduction sought for Medicare.
The Ryan plan on Medicaid proposed that beginning in 2013, the block grants would increase annually at the rate of inflation, with adjustments for population growth, a rate far below that of inflation for health care costs. As a result, states, which have said that they cannot afford to keep up with the program’s costs, are likely to scale back coverage. Such a reduction, critics fear, could have a disproportionate effect on Medicaid spending for nursing home care for the elderly or disabled.
Most Democrats strongly oppose block grants, arguing that such a plan would shift too many Medicaid costs to states that are already slashing their budgets.
Medicaid programs faced other strains as well. In 2009, faced with a deepening recession, the Obama administration injected billions of dollars into Medicaid. But the money was scheduled to last only until the end of June 2011.
Even before it disappeared, states began cutting benefits for millions of people. To hold down costs, states also began cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care.
The health care law passed by Congress in 2010 relies heavily on Medicaid to reach its goal of reducing the number of people without insurance. It is estimated that 16 million more people would be enrolled in Medicaid.
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If liberals care about middle-class salaries, public education and other state-funded services, they need to care about controlling health care costs as much as conservatives do.
January 21, 2012Johnson & Johnson Settles Risperdal Claim in Texas
Johnson & Johnson said it would pay $158 million to end a lawsuit that accused it of inappropriately marketing its Risperdal antipsychotic drug to Texas residents on Medicaid.
January 20, 2012The Pulse: Low Health Revenues Afflict County Budget
Cook County’s revenues fell $166.3 million (7.1 percent) short of expectations in the fiscal year that ended Nov. 30, the county’s interim comptroller said Wednesday.
January 20, 2012Slower Growth in Health Spending
It’s too early to know whether the trend of slower growth will persist after the economy improves, but controlling spending will require reforms.
January 12, 2012Federal Government Criticizes New York on Disabled Care
A report from the Department of Health and Human Services says a state agency lacks independence from the governor’s office and has broken several requirements of federal law.
January 11, 2012
Nicotine Replacement Doesn’t Help Smokers Quit, Study Finds
Nicotine replacements have no lasting benefit in helping smokers quit and may backfire, according to the most rigorous long-term study to date.
January 10, 2012Council to Scrutinize N.Y.C. Schools’ Medicaid Reimbursements
The New York City Council hopes to prod the Education Department to improve collections for eligible services to special-needs students, Speaker Christine C. Quinn said.
January 7, 2012C.D.C. May Lower Threshold for Lead Poisoning
A federal advisory committee has recommended that the Centers for Disease Control and Prevention lower the threshold for diagnosing lead poisoning.
January 06, 2012New York Schools Fail to Get Medicaid Money for Special-Needs Services
New York City has failed to recover tens of millions of dollars in Medicaid reimbursements for services it provided to special-needs students in recent years.
December 29, 2011
Operator of N.Y. Group Homes Thrived Despite Lapses in Care
Bankruptcy filings and the prosecution of officials have not prevented the Federation of Multicultural Programs of Brooklyn from getting $20 million a year to care for developmentally disabled people.
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