Medicaid at Forty-eight

Cindy Mann, Deputy Administrator of the Centers for Medicare & Medicaid services and Director of the Centers for Medicaid and CHIP Services

Since 1965, Medicaid and Medicare have provided comprehensive and affordable health insurance to millions of Americans. Now, 48 years later, Medicaid continues to make strides towards connecting more eligible individuals with coverage and providing quality, affordable care. Now, as of 2013, 56.9 million people are covered by Medicaid, including 27.8 million children, 13.1 million adults and 15 million aged or blind/disabled persons.

 Key Medicaid Coverage Milestones

Children & Babies

                   •    Medicaid plays a key role in child and maternal health, financing approximately 40 percent of all births in the United States.

                   •    According to the Centers for Disease Control and Prevention, the rate of uninsured children dropped from 8.9 percent in 2000 to 6.6 percent in 2012, with millions gaining coverage – mainly through Medicaid and CHIP.

Elderly & Disabled           

•     Medicaid provides health coverage to more than 4.6 million low-income seniors, nearly all of whom are also enrolled in Medicare. Medicaid also provides coverage to 3.7 million people with disabilities who are enrolled in Medicare.

·                   •    Medicaid provides health coverage to over 8.8 million non-elderly individuals with disabilities, including people who are working or who want to work.

 Medicaid Moving Forward

As Medicaid turns 48, the program is evolving and there have been many important improvements to the program to help states across the country prepare for changes under the Affordable Care Act.  The Centers for Medicare & Medicaid Services (CMS) and states are partnering to implement streamlined eligibility rules and systems that will help ensure that eligible beneficiaries can enroll in the program that is right for them, whether Medicaid or coverage through the Health Insurance Marketplace.  And CMS continues to partner with states to improve the way care is delivered to help ensure Medicaid beneficiaries receive high quality health care services.  For example, over the last year, Medicaid has:

                 –  Issued guidance on a new state option for implementing integrated care models without a waiver that help states coordinate care in a fee for service delivery system;

-                                 –   Launched a new website to help states better implement long-term services and supports delivered through a managed care system;

-                                 –  Helped states and consumers to design new person-centered care programs and demonstrations and enhance current programs to improve coordination of care for Medicare-Medicaid enrollees;

-                                 –  Released major new funding opportunities for states and health providers and plans to design and test new delivery system models focused on multi-payer initiatives, new primary care initiatives, and improvements in birth outcomes; and

-                                -  Approved various initiatives to provide additional federal financial support to promote cost effective integrated care for individuals with chronic conditions and to help states improve access to home and community based long term services and supports. 

Medicaid also stands ready to serve more adults as states across the country take up the Medicaid coverage expansion as a result of the Affordable Care Act.  In 2014, states that expand Medicaid coverage to all adults with incomes at or below 133 percent of the federal poverty level can take advantage of 100 percent federal funding for the first three years and never less than 90 percent thereafter, thus extending Medicaid coverage to individuals who have historically been left out of the health insurance market.

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