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class="vector-toc-text"> 3.1 Differences by state </div> </a> <ul id="toc-Differences_by_state-sublist" class="vector-toc-list"> <li id="toc-Political_influences" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Political_influences"> <div class="vector-toc-text"> 3.1.1 Political influences </div> </a> <ul id="toc-Political_influences-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Eligibility_and_coverage" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Eligibility_and_coverage"> <div class="vector-toc-text"> 3.1.2 Eligibility and coverage </div> </a> <ul id="toc-Eligibility_and_coverage-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Reimbursement_for_care_providers" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Reimbursement_for_care_providers"> <div class="vector-toc-text"> 3.1.3 Reimbursement for care providers </div> </a> <ul id="toc-Reimbursement_for_care_providers-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Enrollment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Enrollment"> <div class="vector-toc-text"> 4 Enrollment </div> </a> <ul id="toc-Enrollment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Comparisons_with_Medicare" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Comparisons_with_Medicare"> <div class="vector-toc-text"> 5 Comparisons with Medicare </div> </a> <ul id="toc-Comparisons_with_Medicare-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Benefits" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Benefits"> <div class="vector-toc-text"> 6 Benefits </div> </a> <button aria-controls="toc-Benefits-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Benefits subsection </button> <ul id="toc-Benefits-sublist" class="vector-toc-list"> <li id="toc-Dental" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Dental"> <div class="vector-toc-text"> 6.1 Dental </div> </a> <ul id="toc-Dental-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Eligibility" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Eligibility"> <div class="vector-toc-text"> 7 Eligibility </div> </a> <button aria-controls="toc-Eligibility-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Eligibility subsection </button> <ul id="toc-Eligibility-sublist" class="vector-toc-list"> <li id="toc-PPACA_income_test_standardization" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#PPACA_income_test_standardization"> <div class="vector-toc-text"> 7.1 PPACA income test standardization </div> </a> <ul id="toc-PPACA_income_test_standardization-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Non-PPACA_eligibility" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Non-PPACA_eligibility"> <div class="vector-toc-text"> 7.2 Non-PPACA eligibility </div> </a> <ul id="toc-Non-PPACA_eligibility-sublist" class="vector-toc-list"> <li id="toc-Supplemental_Security_Income_beneficiaries" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Supplemental_Security_Income_beneficiaries"> <div class="vector-toc-text"> 7.2.1 Supplemental Security Income beneficiaries </div> </a> <ul id="toc-Supplemental_Security_Income_beneficiaries-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Five_year_"look-back"" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Five_year_"look-back""> <div class="vector-toc-text"> 7.2.2 Five year "look-back" </div> </a> <ul id="toc-Five_year_"look-back"-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Immigration_status" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Immigration_status"> <div class="vector-toc-text"> 7.2.3 Immigration status </div> </a> <ul id="toc-Immigration_status-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Children_and_SCHIP" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Children_and_SCHIP"> <div class="vector-toc-text"> 7.3 Children and SCHIP </div> </a> <ul id="toc-Children_and_SCHIP-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-HIV" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#HIV"> <div class="vector-toc-text"> 7.4 HIV </div> </a> <ul id="toc-HIV-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Utilization" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Utilization"> <div class="vector-toc-text"> 8 Utilization </div> </a> <ul id="toc-Utilization-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Budget_and_financing" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Budget_and_financing"> <div class="vector-toc-text"> 9 Budget and financing </div> </a> <ul id="toc-Budget_and_financing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Effects" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Effects"> <div class="vector-toc-text"> 10 Effects </div> </a> <button aria-controls="toc-Effects-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Effects subsection </button> <ul id="toc-Effects-sublist" class="vector-toc-list"> <li id="toc-Coverage_gains" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Coverage_gains"> <div class="vector-toc-text"> 10.1 Coverage gains </div> </a> <ul id="toc-Coverage_gains-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mortality_and_disability_reduction" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mortality_and_disability_reduction"> <div class="vector-toc-text"> 10.2 Mortality and disability reduction </div> </a> <ul id="toc-Mortality_and_disability_reduction-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Rural_hospitals_boosted_revenue" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Rural_hospitals_boosted_revenue"> <div class="vector-toc-text"> 10.3 Rural hospitals boosted revenue </div> </a> <ul id="toc-Rural_hospitals_boosted_revenue-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Financial_and_health_security_increase" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Financial_and_health_security_increase"> <div class="vector-toc-text"> 10.4 Financial and health security increase </div> </a> <ul id="toc-Financial_and_health_security_increase-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Political_participation_increase" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Political_participation_increase"> <div class="vector-toc-text"> 10.5 Political participation increase </div> </a> <ul id="toc-Political_participation_increase-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Crime_reduction" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Crime_reduction"> <div class="vector-toc-text"> 10.6 Crime reduction </div> </a> <ul id="toc-Crime_reduction-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Oregon_Medicaid_health_experiment_and_controversy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Oregon_Medicaid_health_experiment_and_controversy"> <div class="vector-toc-text"> 10.7 Oregon Medicaid health experiment and controversy </div> </a> <ul id="toc-Oregon_Medicaid_health_experiment_and_controversy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 11 See also </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 12 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> 13 Further reading </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 14 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Medicaid</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 26 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-26" aria-hidden="true" > 26 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D9%8A%D8%AF%D9%8A%D9%83%D9%8A%D8%AF" title="ميديكيد – Arabic" lang="ar" hreflang="ar" data-title="ميديكيد" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Medicaid" title="Medicaid – Catalan" lang="ca" hreflang="ca" data-title="Medicaid" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Medicaid" title="Medicaid – Danish" lang="da" hreflang="da" data-title="Medicaid" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Medicaid" title="Medicaid – German" lang="de" hreflang="de" data-title="Medicaid" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Medicaid" title="Medicaid – Spanish" lang="es" hreflang="es" data-title="Medicaid" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Medicaid" title="Medicaid – Esperanto" lang="eo" hreflang="eo" data-title="Medicaid" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Medicaid" title="Medicaid – Basque" lang="eu" hreflang="eu" data-title="Medicaid" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%85%D8%AF%DB%8C%DA%A9%DB%8C%D8%AF" title="مدیکید – Persian" lang="fa" hreflang="fa" data-title="مدیکید" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Medicaid" title="Medicaid – French" lang="fr" hreflang="fr" data-title="Medicaid" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%A9%94%EB%94%94%EC%BC%80%EC%9D%B4%EB%93%9C" title="메디케이드 – Korean" lang="ko" hreflang="ko" data-title="메디케이드" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Medicaid" title="Medicaid – Italian" lang="it" hreflang="it" data-title="Medicaid" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D9%85%D9%8A%D8%AF%D9%8A%D9%83%D9%8A%D8%AF" title="ميديكيد – Egyptian Arabic" lang="arz" hreflang="arz" data-title="ميديكيد" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target">مصرى</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Medicaid" title="Medicaid – Dutch" lang="nl" hreflang="nl" data-title="Medicaid" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%A1%E3%83%87%E3%82%A3%E3%82%B1%E3%82%A4%E3%83%89" title="メディケイド – Japanese" lang="ja" hreflang="ja" data-title="メディケイド" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Medicaid" title="Medicaid – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Medicaid" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Medicaid" title="Medicaid – Polish" lang="pl" hreflang="pl" data-title="Medicaid" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Medicaid" title="Medicaid – Portuguese" lang="pt" hreflang="pt" data-title="Medicaid" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9C%D0%B5%D0%B4%D0%B8%D0%BA%D0%B5%D0%B9%D0%B4" title="Медикейд – Russian" lang="ru" hreflang="ru" data-title="Медикейд" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/Medicaid" title="Medicaid – Yakut" lang="sah" hreflang="sah" data-title="Medicaid" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target">Саха тыла</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Medicaid" title="Medicaid – Simple English" lang="en-simple" hreflang="en-simple" data-title="Medicaid" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Medicaid" title="Medicaid – Finnish" lang="fi" hreflang="fi" data-title="Medicaid" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Medicaid" title="Medicaid – Swedish" lang="sv" hreflang="sv" data-title="Medicaid" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9C%D0%B5%D0%B4%D0%B8%D0%BA%D0%B5%D0%B9%D0%B4" title="Медикейд – Ukrainian" lang="uk" hreflang="uk" data-title="Медикейд" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target">Українська</a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Medicaid" title="Medicaid – Vietnamese" lang="vi" hreflang="vi" data-title="Medicaid" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target">Tiếng Việt</a></li><li class="interlanguage-link interwiki-yi mw-list-item"><a href="https://yi.wikipedia.org/wiki/%D7%9E%D7%A2%D7%93%D7%99%D7%A7%D7%A2%D7%99%D7%93" title="מעדיקעיד – Yiddish" lang="yi" hreflang="yi" data-title="מעדיקעיד" data-language-autonym="ייִדיש" data-language-local-name="Yiddish" class="interlanguage-link-target">ייִדיש</a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%81%AF%E9%82%A6%E9%86%AB%E7%99%82%E8%A3%9C%E5%8A%A9" title="聯邦醫療補助 – Chinese" lang="zh" hreflang="zh" data-title="聯邦醫療補助" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target">中文</a></li> </ul> <div class="after-portlet after-portlet-lang"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q1141363#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> 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class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">United States social health care program for families and individuals with limited resources</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Medicare_(United_States)" title="Medicare (United States)">Medicare (United States)</a>.</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><caption class="infobox-title" style="font-size: 125%;">Medicaid</caption><tbody><tr><td colspan="2" class="infobox-image"><a href="/wiki/File:Centers_for_Medicare_and_Medicaid_Services_logo.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Centers_for_Medicare_and_Medicaid_Services_logo.svg/220px-Centers_for_Medicare_and_Medicaid_Services_logo.svg.png" decoding="async" width="220" height="77" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Centers_for_Medicare_and_Medicaid_Services_logo.svg/330px-Centers_for_Medicare_and_Medicaid_Services_logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2a/Centers_for_Medicare_and_Medicaid_Services_logo.svg/440px-Centers_for_Medicare_and_Medicaid_Services_logo.svg.png 2x" data-file-width="353" data-file-height="123" /></a></td></tr><tr><th colspan="2" class="infobox-header" style="background-color: #efefef">Agency overview</th></tr><tr><th scope="row" class="infobox-label">Formed</th><td class="infobox-data">July 30, 1965; 59 years ago (1965-07-30)</td></tr><tr><th scope="row" class="infobox-label">Agency executive</th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"><ul><li style="text-indent: -1em; padding-left: 1em;"><a href="/wiki/Chiquita_Brooks-LaSure" title="Chiquita Brooks-LaSure">Chiquita Brooks-LaSure</a>, Administrator</li></ul></div></td></tr><tr><th scope="row" class="infobox-label">Parent department</th><td class="infobox-data"><a href="/wiki/Centers_for_Medicare_and_Medicaid_Services" class="mw-redirect" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a></td></tr><tr><th scope="row" class="infobox-label">Website</th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://www.medicaid.gov/">www.medicaid.gov</a></td></tr></tbody></table> In the <a href="/wiki/United_States" title="United States">United States</a>, Medicaid is a government program that provides <a href="/wiki/Health_insurance" title="Health insurance">health insurance</a> for adults and children with limited income and resources. The program is partially funded and primarily managed by <a href="/wiki/U.S._state" title="U.S. state">state</a> governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. Medicaid was established in 1965, part of the <a href="/wiki/Great_Society" title="Great Society">Great Society</a> set of programs during <a href="/wiki/Presidency_of_Lyndon_B._Johnson" title="Presidency of Lyndon B. Johnson">President Lyndon Johnson’s Administration</a>, and was significantly expanded by the <a href="/wiki/Affordable_Care_Act" title="Affordable Care Act">Affordable Care Act</a> (ACA), which was passed in 2010. In most states, any member of a household with income up to 138% of the federal <a href="/wiki/Poverty_line_in_the_United_States#Measures_of_poverty" class="mw-redirect" title="Poverty line in the United States">poverty line</a> qualifies for Medicaid coverage under the provisions of the ACA.<a href="#cite_note-1">[1]</a> A 2012 <a href="/wiki/Supreme_Court_of_the_United_States" title="Supreme Court of the United States">Supreme Court</a> decision established that states may continue to use pre-ACA Medicaid eligibility standards and receive previously established levels of federal Medicaid funding; in states that make that choice, income limits may be significantly lower, and able-bodied adults may not be eligible for Medicaid at all.<a href="#cite_note-:4-2">[2]</a> Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022;<a href="#cite_note-Medicaid_gov_2022-12_data-3">[3]</a> in 2019, the program paid for half of all U.S. births.<a href="#cite_note-Franco-4">[4]</a> As of 2017, the total annual cost of Medicaid was just over $600 billion, of which the federal government contributed $375 billion and states an additional $230 billion.<a href="#cite_note-Franco-4">[4]</a> States are not required to participate in the program, although all have since 1982. In general, Medicaid recipients must be <a href="/wiki/Citizenship_in_the_United_States" class="mw-redirect" title="Citizenship in the United States">U.S. citizens</a> or qualified non-citizens, and may include low-income adults, their children, and people with certain <a href="/wiki/Disability" title="Disability">disabilities</a>.<a href="#cite_note-5">[5]</a> As of 2022<a class="external text" href="https://en.wikipedia.org/w/index.php?title=Medicaid&action=edit">[update]</a> 45% of those receiving Medicaid or <a href="/wiki/Children%27s_Health_Insurance_Program" title="Children's Health Insurance Program">CHIP</a> were children.<a href="#cite_note-Medicaid_gov_2022-12_data-3">[3]</a> Medicaid also covers long-term services and supports, including both nursing home care and home- and community-based services, for those with low incomes and minimal assets; the exact qualifications vary by state. Medicaid spent $215 billion on such care in 2020, over half of the total $402 billion spent on such services.<a href="#cite_note-6">[6]</a> Of the 7.7 million Americans who used long-term services and supports in 2020, about 5.6 million were covered by Medicaid, including 1.6 million of the 1.9 million in institutional settings.<a href="#cite_note-7">[7]</a> Medicaid covers healthcare costs for people with low incomes, while <a href="/wiki/Medicare_(United_States)" title="Medicare (United States)">Medicare</a> is a universal program providing health coverage for the elderly. Medicaid offers elder care benefits not normally covered by Medicare, including nursing home care and personal care services. There are also dual health plans for people who have both Medicaid and Medicare.<a href="#cite_note-8">[8]</a> Along with Medicare, <a href="/wiki/Tricare" title="Tricare">Tricare</a>, and <a href="/wiki/Veterans_Health_Administration#Non-Medical_Programs" title="Veterans Health Administration">ChampVA</a>, Medicaid is one of the four government-sponsored <a href="/wiki/Medical_insurance" class="mw-redirect" title="Medical insurance">medical insurance</a> programs in the United States. The U.S. Centers for Medicare & Medicaid Services in <a href="/wiki/Baltimore" title="Baltimore">Baltimore</a>, <a href="/wiki/Maryland" title="Maryland">Maryland</a> provides federal oversight.<a href="#cite_note-official-9">[9]</a> Research shows that existence of the Medicaid program improves health outcomes, health insurance coverage, access to health care, and recipients' financial security and provides economic benefits to states and health providers.<a href="#cite_note-:1-10">[10]</a><a href="#cite_note-:7-11">[11]</a><a href="#cite_note-12">[12]</a><a href="#cite_note-:8-13">[13]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Features">Features</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=1" title="Edit section: Features">edit</a>]</div> Beginning in the 1980s, many states received waivers from the federal government to create <a href="/wiki/Medicaid_managed_care" title="Medicaid managed care">Medicaid managed care</a> programs. Under managed care, Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. The health plan is then responsible for providing for all or most of the recipient's healthcare needs. Today, all but a few states use managed care to provide coverage to a significant proportion of Medicaid enrollees. As of 2014, 26 states have contracts with <a href="/wiki/Managed_Care_Organization" class="mw-redirect" title="Managed Care Organization">managed care organizations</a> (MCOs) to deliver long-term care for the elderly and individuals with disabilities. The states pay a monthly capitated rate per member to the MCOs, which in turn provide comprehensive care and accept the risk of managing total costs.<a href="#cite_note-14">[14]</a> Nationwide, roughly 80% of Medicaid enrollees are enrolled in managed care plans.<a href="#cite_note-15">[15]</a> Core eligibility groups of low-income families are most likely to be enrolled in managed care, while the "aged" and "disabled" eligibility groups more often remain in traditional "<a href="/wiki/Fee_for_service" class="mw-redirect" title="Fee for service">fee for service</a>" Medicaid. Because service level costs vary depending on the care and needs of the enrolled, a cost per person average is only a rough measure of actual cost of care. The annual cost of care will vary state to state depending on state approved Medicaid benefits, as well as the state specific care costs. A 2014 <a href="/wiki/Kaiser_Family_Foundation" title="Kaiser Family Foundation">Kaiser Family Foundation</a> report estimates the national average per capita annual cost of Medicaid services for children to be $2,577, adults to be $3,278, persons with disabilities to be $16,859, aged persons (65+) to be $13,063, and all Medicaid enrollees to be $5,736.<a href="#cite_note-16">[16]</a> <div class="mw-heading mw-heading2"><h2 id="History">History</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=2" title="Edit section: History">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl 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.sidebar:not(.notheme) .sidebar-title-with-pretitle{background:transparent!important}html.skin-theme-clientpref-os .mw-parser-output .sidebar:not(.notheme) .sidebar-title-with-pretitle a{color:var(--color-progressive)!important}}@media print{body.ns-0 .mw-parser-output .sidebar{display:none!important}}</style><table class="sidebar sidebar-collapse nomobile"><tbody><tr><th class="sidebar-title" style="background: #fcc"><a href="/wiki/Healthcare_in_the_United_States" title="Healthcare in the United States">Healthcare in the United States</a></th></tr><tr><td class="sidebar-content" style="text-align:left;border-bottom:1px #aaa solid;"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="color: var(--color-base)">Government health programs</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Federal_Employees_Health_Benefits_Program" title="Federal Employees Health Benefits Program">Federal Employees Health Benefits Program</a> (FEHBP)</li> <li><a href="/wiki/Indian_Health_Service" title="Indian Health Service">Indian Health Service</a> (IHS)</li> <li><a class="mw-selflink selflink">Medicaid</a> / State Health Insurance Assistance Program (SHIP)</li> <li><a href="/wiki/Medicare_(United_States)" title="Medicare (United States)">Medicare</a></li> <li>Prescription Assistance (SPAP)</li> <li><a href="/wiki/Military_Health_System" title="Military Health System">Military Health System</a> (MHS) / <a href="/wiki/Tricare" title="Tricare">Tricare</a></li> <li><a href="/wiki/Children%27s_Health_Insurance_Program" title="Children's Health Insurance Program">Children's Health Insurance Program</a> (CHIP)</li> <li><a href="/wiki/Program_of_All-Inclusive_Care_for_the_Elderly" title="Program of All-Inclusive Care for the Elderly">Program of All-Inclusive Care for the Elderly</a> (PACE)</li> <li><a href="/wiki/Veterans_Health_Administration" title="Veterans Health Administration">Veterans Health Administration</a> (VHA)</li></ul></div></div></td> </tr><tr><td class="sidebar-content" style="text-align:left;border-bottom:1px #aaa solid;"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="color: var(--color-base)">Private health coverage</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Consumer-driven_healthcare" title="Consumer-driven healthcare">Consumer-driven healthcare</a> <ul><li><a href="/wiki/Flexible_spending_account" title="Flexible spending account">Flexible spending account</a> (FSA)</li> <li><a href="/wiki/Health_reimbursement_account" title="Health reimbursement account">Health reimbursement account</a> (HRA)</li> <li><a href="/wiki/Health_savings_account" title="Health savings account">Health savings account</a> (HSA) <ul><li><a href="/wiki/High-deductible_health_plan" title="High-deductible health plan">High-deductible health plan</a> (HDHP)</li> <li><a href="/wiki/Medical_savings_account_(United_States)" title="Medical savings account (United States)">Medical savings account</a> (MSA)</li></ul></li> <li>Private Fee-For-Service (PFFS)</li></ul></li> <li><a href="/wiki/Health_insurance_in_the_United_States" title="Health insurance in the United States">Health insurance in the United States</a> <ul><li><a href="/wiki/Health_insurance_marketplace" title="Health insurance marketplace">Health insurance marketplaces</a></li> <li><a href="/wiki/Premium_tax_credit" title="Premium tax credit">Premium tax credit</a></li></ul></li> <li><a href="/wiki/Managed_care" title="Managed care">Managed care</a> (CCP) <ul><li><a href="/wiki/Exclusive_provider_organization" title="Exclusive provider organization">Exclusive provider organization</a> (EPO)</li> <li><a href="/wiki/Health_maintenance_organization" title="Health maintenance organization">Health maintenance organization</a> (HMO)</li> <li><a href="/wiki/Preferred_provider_organization" title="Preferred provider organization">Preferred provider organization</a> (PPO)</li></ul></li> <li><a href="/wiki/Medical_underwriting" title="Medical underwriting">Medical underwriting</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content" style="text-align:left;border-bottom:1px #aaa solid;"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="color: var(--color-base)"><a href="/wiki/Healthcare_reform_in_the_United_States" title="Healthcare reform in the United States">Health care reform</a> law</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act" title="Emergency Medical Treatment and Active Labor Act">Emergency Medical Treatment and Active Labor Act</a> (1986)</li> <li><a href="/wiki/Health_Insurance_Portability_and_Accountability_Act" title="Health Insurance Portability and Accountability Act">Health Insurance Portability and Accountability Act</a> (1996)</li> <li><a href="/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act" title="Medicare Prescription Drug, Improvement, and Modernization Act">Medicare Prescription Drug, Improvement, and Modernization Act</a> (2003)</li> <li><a href="/wiki/Patient_Safety_and_Quality_Improvement_Act" title="Patient Safety and Quality Improvement Act">Patient Safety and Quality Improvement Act</a> (2005)</li> <li><a href="/wiki/Health_Information_Technology_for_Economic_and_Clinical_Health_Act" title="Health Information Technology for Economic and Clinical Health Act">Health Information Technology for Economic and Clinical Health Act</a> (2009)</li> <li><a href="/wiki/Patient_Protection_and_Affordable_Care_Act" class="mw-redirect" title="Patient Protection and Affordable Care Act">Patient Protection and Affordable Care Act</a> (2010)</li></ul></div></div></td> </tr><tr><td class="sidebar-content" style="text-align:left;border-bottom:1px #aaa solid;"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="color: var(--color-base)">State level reform</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Dirigo_Health" title="Dirigo Health">Dirigo Health</a> (<a href="/wiki/Maine" title="Maine">Maine</a>)</li> <li><a href="/wiki/Massachusetts_health_care_reform" title="Massachusetts health care reform">Massachusetts health care reform</a></li> <li><a href="/wiki/Oregon_Health_Plan" title="Oregon Health Plan">Oregon Health Plan</a></li> <li><a href="/wiki/SustiNet" class="mw-redirect" title="SustiNet">SustiNet</a> (<a href="/wiki/Connecticut" title="Connecticut">Connecticut</a>)</li> <li><a href="/wiki/Vermont_health_care_reform" title="Vermont health care reform">Vermont health care reform</a></li></ul></div></div></td> </tr><tr><td class="sidebar-content" style="text-align:left;border-bottom:1px #aaa solid;"> <div class="sidebar-list mw-collapsible mw-collapsed"><div class="sidebar-list-title" style="color: var(--color-base)">Municipal health coverage</div><div class="sidebar-list-content mw-collapsible-content"> <ul><li><a href="/wiki/Healthcare_in_California" title="Healthcare in California">Healthcare in California</a> <ul><li><a href="/wiki/Healthy_San_Francisco" title="Healthy San Francisco">Healthy San Francisco</a></li> <li><a href="/wiki/Healthy_Way_LA" title="Healthy Way LA">Healthy Way LA</a></li> <li><a href="/wiki/My_Health_LA" title="My Health LA">My Health LA</a></li></ul></li> <li><a href="/wiki/Fair_Share_Health_Care_Act" title="Fair Share Health Care Act">Fair Share Health Care Act</a> (Maryland)</li> <li><a href="/wiki/Healthy_Howard" title="Healthy Howard">Healthy Howard</a> (Howard Co., Maryland)</li></ul></div></div></td> </tr><tr><td class="sidebar-navbar"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Health_care_in_the_United_States" title="Template:Health care in the United States"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Health_care_in_the_United_States" title="Template talk:Health care in the United States"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Health_care_in_the_United_States" title="Special:EditPage/Template:Health care in the United States"><abbr title="Edit this template">e</abbr></a></li></ul></div></td></tr></tbody></table> The <a href="/wiki/Social_Security_Amendments_of_1965" title="Social Security Amendments of 1965">Social Security Amendments of 1965</a> created Medicaid by adding <a href="/wiki/Social_Security_Act#Title_XIX—Grants_to_States_for_Medical_Assistance_Programs" title="Social Security Act">Title XIX</a> to the <a href="/wiki/Social_Security_Act" title="Social Security Act">Social Security Act</a>, 42 U.S.C. §§ 1396 et seq. Under the program, the federal government provided matching funds to states to enable them to provide Medical Assistance to residents who met certain eligibility requirements. The objective was to help states assist residents whose income and resources were insufficient to pay the costs of traditional commercial health insurance plans. By 1982, all states were participating. The last state to do so was Arizona. The <a href="/wiki/Medicaid_Drug_Rebate_Program" title="Medicaid Drug Rebate Program">Medicaid Drug Rebate Program</a> and the <a href="/wiki/Health_Insurance_Premium_Payment_Program" title="Health Insurance Premium Payment Program">Health Insurance Premium Payment Program</a> (HIPP) were created by the <a href="/wiki/Omnibus_Budget_Reconciliation_Act_of_1990" title="Omnibus Budget Reconciliation Act of 1990">Omnibus Budget Reconciliation Act of 1990</a> (OBRA-90). This act helped to add Section 1927 to the Social Security Act of 1935 and became effective on January 1, 1991. This program was formed due to the costs that Medicaid programs were paying for discount price outpatient drugs.<a href="#cite_note-autogenerated3-17">[17]</a> The <a href="/wiki/Omnibus_Budget_Reconciliation_Act_of_1993" title="Omnibus Budget Reconciliation Act of 1993">Omnibus Budget Reconciliation Act of 1993</a> (OBRA-93) amended Section 1927 of the Act, bringing changes to the Medicaid Drug Rebate Program.<a href="#cite_note-autogenerated3-17">[17]</a> It requires states to implement a <a href="/wiki/Medicaid_estate_recovery" class="mw-redirect" title="Medicaid estate recovery">Medicaid estate recovery</a> program to recover from the estate of deceased beneficiaries the long-term-care-related costs paid by Medicaid, and gives states the option of recovering all non-long-term-care costs, including full medical costs.<a href="#cite_note-:9-18">[18]</a> Medicaid also offers a Fee for Service (Direct Service) Program to schools throughout the United States for the reimbursement of costs associated with the services delivered to students with <a href="/wiki/Special_education" title="Special education">special education</a> needs.<a href="#cite_note-19">[19]</a> Federal law mandates that children with disabilities receive a "free appropriate public education" under Section 504 of The Rehabilitation Act of 1973.<a href="#cite_note-20">[20]</a> Decisions by the United States Supreme Court and subsequent changes in federal law require states to reimburse part or all of the cost of some services provided by schools for Medicaid-eligible disabled children. <div class="mw-heading mw-heading3"><h3 id="Expansion_under_the_Affordable_Care_Act">Expansion under the Affordable Care Act</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=3" title="Edit section: Expansion under the Affordable Care Act">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Medicaid_expansion_map_of_US._Affordable_Care_Act.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Medicaid_expansion_map_of_US._Affordable_Care_Act.svg/300px-Medicaid_expansion_map_of_US._Affordable_Care_Act.svg.png" decoding="async" width="300" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Medicaid_expansion_map_of_US._Affordable_Care_Act.svg/450px-Medicaid_expansion_map_of_US._Affordable_Care_Act.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/47/Medicaid_expansion_map_of_US._Affordable_Care_Act.svg/600px-Medicaid_expansion_map_of_US._Affordable_Care_Act.svg.png 2x" data-file-width="512" data-file-height="341" /></a><figcaption><a href="/wiki/Medicaid_coverage_gap#Medicaid_expansion" title="Medicaid coverage gap">ACA Medicaid expansion</a> by state:<a href="#cite_note-KFF-Medicaid-21">[21]</a> <style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend">  Not adopted</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  Adopted</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  Implemented</div></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png/300px-Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png" decoding="async" width="300" height="238" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png/450px-Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png/600px-Uninsured_Rate_Comparing_Medicaid_Expansion_States_vs._Non_Expansion.png 2x" data-file-width="984" data-file-height="779" /></a><figcaption>States that expanded Medicaid under ACA had a lower uninsured rate in 2018 at various income levels.<a href="#cite_note-Census_2018-22">[22]</a></figcaption></figure> The <a href="/wiki/Affordable_Care_Act" title="Affordable Care Act">Affordable Care Act</a> (ACA), passed in 2010, substantially expanded the Medicaid program. Before the law was passed, some states did not allow able-bodied adults to participate in Medicaid, and many set income eligibility far below the Federal poverty level. Under the provisions of the law, any state that participated in Medicaid would need to expand coverage to include anyone earning up to 138% of the Federal poverty level beginning in 2014. The costs of the newly covered population would initially be covered in full by the Federal government, although states would need to pay for 10% of those costs by 2020.<a href="#cite_note-23">[23]</a><a href="#cite_note-24">[24]</a><a href="#cite_note-25">[25]</a><a href="#cite_note-26">[26]</a> However, in 2012, the Supreme Court held in <a href="/wiki/National_Federation_of_Independent_Business_v._Sebelius" title="National Federation of Independent Business v. Sebelius">National Federation of Independent Business v. Sebelius</a> that withdrawing all Medicaid funding from states that refused to expand eligibility was unconstitutionally coercive. States could choose to maintain pre-existing levels of Medicaid funding and eligibility, and some did; over half the national uninsured population lives in those states.<a href="#cite_note-NYT52413-27">[27]</a> As of March 2023, 40 states have accepted the <a href="/wiki/Affordable_Care_Act" title="Affordable Care Act">Affordable Care Act</a> Medicaid extension, as has the <a href="/wiki/Washington,_D.C." title="Washington, D.C.">District of Columbia</a>, which has its own Medicaid program; 10 states have not.<a href="#cite_note-KFF_States-28">[28]</a> Among adults aged 18 to 64, states that expanded Medicaid had an uninsured rate of 7.3% in the first quarter of 2016, while non-expansion states had a 14.1% uninsured rate.<a href="#cite_note-Urban_Q12016-29">[29]</a> The <a href="/wiki/Centers_for_Medicare_and_Medicaid_Services" class="mw-redirect" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> (CMS) estimated that the cost of expansion was $6,366 per person for 2015, about 49 percent above previous estimates. An estimated 9 to 10 million people had gained Medicaid coverage, mostly low-income adults.<a href="#cite_note-:10-30">[30]</a> The Kaiser Family Foundation estimated in October 2015 that 3.1 million additional people were not covered in states that rejected the Medicaid expansion.<a href="#cite_note-31">[31]</a> In some states that chose not to expand Medicaid, income eligibility thresholds are significantly below 133% of the poverty line.<a href="#cite_note-Kliff,_Sarah-32">[32]</a> Some of these states do not make Medicaid available to non-pregnant adults without disabilities or dependent children, no matter their income. Because subsidies on commercial insurance plans are not available to such individuals, most have few options for obtaining any medical insurance.<a href="#cite_note-33">[33]</a><a href="#cite_note-Families_USA-34">[34]</a> For example, in <a href="/wiki/Kansas" title="Kansas">Kansas</a>, where only non-disabled adults with children and with an income below 32% of the poverty line were eligible for Medicaid, those with incomes from 32% to 100% of the poverty level ($6,250 to $19,530 for a family of three) were ineligible for both Medicaid and federal subsidies to buy insurance.<a href="#cite_note-NYT52413-27">[27]</a> Studies of the impact of Medicaid expansion rejections calculated that up to 6.4 million people would have too much income for Medicaid but not qualify for exchange subsidies.<a href="#cite_note-35">[35]</a> Several states argued that they could not afford the 10% contribution in 2020.<a href="#cite_note-CNNMedicaid-36">[36]</a><a href="#cite_note-Medicaiddeal-37">[37]</a> Some studies suggested that rejecting the expansion would cost more due to increased spending on uncompensated <a href="/wiki/Emergency_care" class="mw-redirect" title="Emergency care">emergency care</a> that otherwise would have been partially paid for by Medicaid coverage.<a href="#cite_note-38">[38]</a> A 2016 study found that residents of <a href="/wiki/Kentucky" title="Kentucky">Kentucky</a> and <a href="/wiki/Arkansas" title="Arkansas">Arkansas</a>, which both expanded Medicaid, were more likely to receive health care services and less likely to incur emergency room costs or have trouble paying their medical bills. Residents of <a href="/wiki/Texas" title="Texas">Texas</a>, which did not accept the Medicaid expansion, did not see a similar improvement during the same period.<a href="#cite_note-39">[39]</a> Kentucky opted for increased managed care, while Arkansas subsidized private insurance. Later, Arkansas and Kentucky governors proposed reducing or modifying their programs. From 2013 to 2015, the uninsured rate dropped from 42% to 14% in Arkansas and from 40% to 9% in Kentucky, compared with 39% to 32% in Texas.<a href="#cite_note-40">[40]</a> A 2016 <a href="/wiki/United_States_Department_of_Health_and_Human_Services" title="United States Department of Health and Human Services">DHHS</a> study found that states that expanded Medicaid had lower premiums on exchange policies because they had fewer low-income enrollees, whose health, on average, is worse than that of people with higher income.<a href="#cite_note-41">[41]</a> The <a href="/wiki/United_States_Census_Bureau" title="United States Census Bureau">Census Bureau</a> reported in September 2019 that states that expanded Medicaid under ACA had considerably lower uninsured rates than states that did not. For example, for adults between 100% and 399% of poverty level, the uninsured rate in 2018 was 12.7% in expansion states and 21.2% in non-expansion states. Of the 14 states with uninsured rates of 10% or greater, 11 had not expanded Medicaid.<a href="#cite_note-Census_2018-22">[22]</a> A July 2019 study by the National Bureau of Economic Research (NBER) indicated that states enacting Medicaid expansion exhibited statistically significant reductions in mortality rates.<a href="#cite_note-42">[42]</a> The ACA was structured with the assumption that Medicaid would cover anyone making less than 133% of the Federal poverty level throughout the United States; as a result, premium tax credits are only available to individuals buying private health insurance through <a href="/wiki/Health_insurance_marketplace" title="Health insurance marketplace">exchanges</a> if they make more than that amount. This has given rise to the so-called <a href="/wiki/Medicaid_coverage_gap" title="Medicaid coverage gap">Medicaid coverage gap</a> in states that have not expanded Medicaid: there are people whose income is too high to qualify for Medicaid in those states, but too low to receive assistance in paying for private health insurance, which is therefore unaffordable to them.<a href="#cite_note-43">[43]</a> <div class="mw-heading mw-heading2"><h2 id="State_implementations">State implementations</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=4" title="Edit section: State implementations">edit</a>]</div> States may bundle together the administration of Medicaid with other programs such as the <a href="/wiki/Children%27s_Health_Insurance_Program" title="Children's Health Insurance Program">Children's Health Insurance Program</a> (CHIP), so the same organization that handles Medicaid in a state may also manage the additional programs. Separate programs may also exist in some localities that are funded by the states or their political subdivisions to provide health coverage for indigents and minors. State participation in Medicaid is voluntary; however, all states have participated since 1982. In some states Medicaid is subcontracted to private health insurance companies, while other states pay providers (i.e., doctors, clinics and hospitals) directly. There are many services that can fall under Medicaid and some states support more services than other states. The most provided services are intermediate care for mentally disabled, prescription drugs and nursing facility care for under 21-year-olds. The least provided services include institutional religious (non-medical) health care, respiratory care for ventilator dependent and PACE (inclusive <a href="/wiki/Elderly_care" title="Elderly care">elderly care</a>).<a href="#cite_note-44">[44]</a> Most states administer Medicaid through their own programs. A few of those programs are listed below: <ul><li><a href="/wiki/Arizona" title="Arizona">Arizona</a>: <a href="/wiki/Arizona_Health_Care_Cost_Containment_System" class="mw-redirect" title="Arizona Health Care Cost Containment System">AHCCCS</a></li> <li><a href="/wiki/California" title="California">California</a>: <a href="/wiki/Medi-Cal" title="Medi-Cal">Medi-Cal</a></li> <li><a href="/wiki/Connecticut" title="Connecticut">Connecticut</a>: <a href="/w/index.php?title=HUSKY_D&action=edit&redlink=1" class="new" title="HUSKY D (page does not exist)">HUSKY D</a></li> <li><a href="/wiki/Maine" title="Maine">Maine</a>: MaineCare</li> <li><a href="/wiki/Massachusetts" title="Massachusetts">Massachusetts</a>: <a href="/wiki/MassHealth" class="mw-redirect" title="MassHealth">MassHealth</a></li> <li><a href="/wiki/New_Jersey" title="New Jersey">New Jersey</a>: <a rel="nofollow" class="external text" href="https://njfamilycare.dhs.state.nj.us/">NJ FamilyCare</a></li> <li><a href="/wiki/Oregon" title="Oregon">Oregon</a>: <a href="/wiki/Oregon_Health_Plan" title="Oregon Health Plan">Oregon Health Plan</a></li> <li><a href="/wiki/Oklahoma" title="Oklahoma">Oklahoma</a>: <a href="/wiki/Soonercare" class="mw-redirect" title="Soonercare">Soonercare</a></li> <li><a href="/wiki/Tennessee" title="Tennessee">Tennessee</a>: <a href="/wiki/TennCare" title="TennCare">TennCare</a></li> <li><a href="/wiki/Washington_(state)" title="Washington (state)">Washington</a>: <a href="/wiki/Washington_Apple_Health" title="Washington Apple Health">Washington Apple Health</a></li> <li><a href="/wiki/Wisconsin" title="Wisconsin">Wisconsin</a>: <a href="/wiki/BadgerCare" title="BadgerCare">BadgerCare</a></li></ul> As of January 2012, Medicaid and/or CHIP funds could be obtained to help pay employer health care premiums in <a href="/wiki/Alabama" title="Alabama">Alabama</a>, <a href="/wiki/Alaska" title="Alaska">Alaska</a>, Arizona, <a href="/wiki/Colorado" title="Colorado">Colorado</a>, <a href="/wiki/Florida" title="Florida">Florida</a>, and <a href="/wiki/Georgia_(U.S._state)" title="Georgia (U.S. state)">Georgia</a>.<a href="#cite_note-45">[45]</a> <div class="mw-heading mw-heading3"><h3 id="Differences_by_state">Differences by state</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=5" title="Edit section: Differences by state">edit</a>]</div> States must comply with federal law, under which each participating state administers its own Medicaid program, establishes eligibility standards, determines the scope and types of services it will cover, and sets the rate of reimbursement physicians and care providers. Differences between states are often influenced by the political ideologies of the state and cultural beliefs of the general population. The federal <a href="/wiki/Centers_for_Medicare_and_Medicaid_Services" class="mw-redirect" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> (CMS) closely monitors each state's program and establishes requirements for service delivery, quality, funding, and eligibility standards.<a href="#cite_note-46">[46]</a> <a href="/wiki/Medicaid_estate_recovery" class="mw-redirect" title="Medicaid estate recovery">Medicaid estate recovery</a> regulations also vary by state. (Federal law gives options as to whether non-long-term-care-related expenses, such as normal health-insurance-type medical expenses are to be recovered, as well as on whether the recovery is limited to probate estates or extends beyond.)<a href="#cite_note-:9-18">[18]</a> <div class="mw-heading mw-heading4"><h4 id="Political_influences">Political influences</h4>[<a href="/w/index.php?title=Medicaid&action=edit&section=6" title="Edit section: Political influences">edit</a>]</div> Several political factors influence the cost and eligibility of tax-funded health care. According to a study conducted by Gideon Lukens, factors significantly affecting eligibility included "party control, the ideology of state citizens, the prevalence of women in legislatures, the line-item veto, and physician interest group size". Lukens' study supported the generalized hypothesis that <a href="/wiki/Democratic_Party_(United_States)" title="Democratic Party (United States)">Democrats</a> favor generous eligibility policies while <a href="/wiki/Republican_Party_(United_States)" title="Republican Party (United States)">Republicans</a> do not.<a href="#cite_note-47">[47]</a> When the Supreme Court allowed states to decide whether to expand Medicaid or not in 2012, northern states, in which Democratic legislators predominated, disproportionately did so, often also extending existing eligibility.<a href="#cite_note-:11-48">[48]</a> Certain states in which there is a Republican-controlled legislature may be forced to expand Medicaid in ways extending beyond increasing existing eligibility in the form of waivers for certain Medicaid requirements so long as they follow certain objectives. In its implementation, this has meant using Medicaid funds to pay for low-income citizens' health insurance; this private-option was originally carried out in Arkansas but was adopted by other Republican-led states.<a href="#cite_note-:11-48">[48]</a> However, private coverage is more expensive than Medicaid and the states would not have to contribute as much to the cost of private coverage.<a href="#cite_note-49">[49]</a> Certain groups of people, such as migrants, face more barriers to health care than others due to factors besides policy, such as status, transportation and knowledge of the healthcare system (including eligibility).<a href="#cite_note-50">[50]</a> <div class="mw-heading mw-heading4"><h4 id="Eligibility_and_coverage">Eligibility and coverage</h4>[<a href="/w/index.php?title=Medicaid&action=edit&section=7" title="Edit section: Eligibility and coverage">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-More_citations_needed_section plainlinks metadata ambox ambox-content ambox-Refimprove" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></div></td><td class="mbox-text"><div class="mbox-text-span">This section needs additional citations for <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">verification</a>. Please help <a href="/wiki/Special:EditPage/Medicaid" title="Special:EditPage/Medicaid">improve this article</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a> in this section. Unsourced material may be challenged and removed. (July 2020) (<a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a>)</div></td></tr></tbody></table> Medicaid eligibility policies are very complicated. In general, a person's Medicaid eligibility is linked to their eligibility for <a href="/wiki/Aid_to_Families_with_Dependent_Children" title="Aid to Families with Dependent Children">Aid to Families with Dependent Children</a> (AFDC), which provides aid to children whose families have low or no income, and to the <a href="/wiki/Supplemental_Security_Income" title="Supplemental Security Income">Supplemental Security Income</a> (SSI) program for the aged, blind and disabled. States are required under federal law to provide all AFDC and SSI recipients with Medicaid coverage. Because eligibility for AFDC and SSI essentially guarantees Medicaid coverage, examining eligibility/coverage differences per state in AFDC and SSI is an accurate way to assess Medicaid differences as well. SSI coverage is largely consistent by state, and requirements on how to qualify or what benefits are provided are standard. However AFDC has differing eligibility standards that depend on: <ol><li>The Low-Income Wage Rate: State welfare programs base the level of assistance they provide on some concept of what is minimally necessary.</li> <li>Perceived Incentive for Welfare Migration. Not only do social norms within the state affect its determination of AFDC payment levels, but regional norms will affect a state's perception of need as well.</li></ol> <div class="mw-heading mw-heading4"><h4 id="Reimbursement_for_care_providers">Reimbursement for care providers</h4>[<a href="/w/index.php?title=Medicaid&action=edit&section=8" title="Edit section: Reimbursement for care providers">edit</a>]</div> Beyond the variance in eligibility and coverage between states, there is a large variance in the reimbursements Medicaid offers to care providers; the clearest examples of this are common <a href="/wiki/Orthopedic_surgery" title="Orthopedic surgery">orthopedic procedures</a>. For instance, in 2013, the average difference in reimbursement for 10 common orthopedic procedures in the states of New Jersey and <a href="/wiki/Delaware" title="Delaware">Delaware</a> was $3,047.<a href="#cite_note-51">[51]</a> The discrepancy in the reimbursements Medicaid offers may affect the type of care provided to patients. In general, Medicaid plans pay providers significantly less than commercial insurers or Medicare would pay for the same care, paying around 67% as much as Medicare would for primary care and 78% as much for other services. This disparity has been linked to lower provider rates of participation in Medicaid programs vs Medicare or commercial insurance, and thus decreased access to care for Medicaid patients.<a href="#cite_note-52">[52]</a> One component of the Affordable Care Act was a federally-funded increase in 2013 and 2014 in Medicaid payments to bring them up to 100% of equivalent Medicare payments, in an effort to increase provider participation. Most states did not subsequently continue this provision.<a href="#cite_note-53">[53]</a> <div class="mw-heading mw-heading2"><h2 id="Enrollment">Enrollment</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=9" title="Edit section: Enrollment">edit</a>]</div> In 2002, Medicaid enrollees numbered 39.9 million Americans, with the largest group being children (18.4 million or 46%).<a href="#cite_note-54">[54]</a> From 2000 to 2012, the proportion of hospital stays for children paid by Medicaid increased by 33% and the proportion paid by private insurance decreased by 21%.<a href="#cite_note-55">[55]</a> Some 43 million Americans were enrolled in 2004 (19.7 million of them children) at a total cost of $295 billion. In 2008, Medicaid provided health coverage and services to approximately 49 million low-income children, pregnant women, elderly people, and disabled people. In 2009, 62.9 million Americans were enrolled in Medicaid for at least one month, with an average enrollment of 50.1 million.<a href="#cite_note-56">[56]</a> In <a href="/wiki/California" title="California">California</a>, about 23% of the population was enrolled in <a href="/wiki/Medi-Cal" title="Medi-Cal">Medi-Cal</a> for at least 1 month in 2009–10.<a href="#cite_note-57">[57]</a> As of 2017, the total annual cost of Medicaid was just over $600 billion, of which the federal government contributed $375 billion and states an additional $230 billion.<a href="#cite_note-Franco-4">[4]</a> According to CMS, the Medicaid program provided health care services to more than 92 million people in 2022.<a href="#cite_note-58">[58]</a> Loss of income and medical insurance coverage during the <a href="/wiki/2008_recession" class="mw-redirect" title="2008 recession">2008–2009 recession</a> resulted in a substantial increase in Medicaid enrollment in 2009. Nine U.S. states showed an increase in enrollment of 15% or more, putting a heavy strain on state budgets.<a href="#cite_note-59">[59]</a> The Kaiser Family Foundation reported that for 2013, Medicaid recipients were 40% white, 21% black, 25% Hispanic, and 14% other races.<a href="#cite_note-60">[60]</a> <div class="mw-heading mw-heading2"><h2 id="Comparisons_with_Medicare">Comparisons with Medicare</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=10" title="Edit section: Comparisons with Medicare">edit</a>]</div> Unlike Medicaid, <a href="/wiki/Medicare_(United_States)" title="Medicare (United States)">Medicare</a> is a <a href="/wiki/Social_insurance" title="Social insurance">social insurance</a> program funded at the federal level and focuses primarily on the older population.<a href="#cite_note-61">[61]</a> Medicare is a <a href="/wiki/Health_insurance_in_the_United_States" title="Health insurance in the United States">health insurance</a> program for people age 65 or older, people under age 65 with certain disabilities, and (through the <a href="/wiki/End_Stage_Renal_Disease_Program" title="End Stage Renal Disease Program">End Stage Renal Disease Program</a>) people of all ages with <a href="/wiki/End-stage_renal_disease" class="mw-redirect" title="End-stage renal disease">end-stage renal disease</a>.<a href="#cite_note-:3-62">[62]</a> The Medicare Program provides a Medicare part A covering hospital bills, Medicare Part B covering medical insurance coverage, and Medicare Part D covering purchase of <a href="/wiki/Prescription_drug" title="Prescription drug">prescription drugs</a>. Medicaid is a program that is not solely funded at the federal level. States provide up to half of the funding for Medicaid. In some states, counties also contribute funds. Unlike Medicare, Medicaid is a <a href="/wiki/Means-tested" class="mw-redirect" title="Means-tested">means-tested</a>, <a href="/wiki/Needs-based" class="mw-redirect" title="Needs-based">needs-based</a> <a href="/wiki/Social_welfare_provision" class="mw-redirect" title="Social welfare provision">social welfare</a> or <a href="/wiki/Social_security#Social_protection" class="mw-redirect" title="Social security">social protection</a> program rather than a <a href="/wiki/Social_insurance" title="Social insurance">social insurance</a> program. Eligibility is determined largely by income. The main criterion for Medicaid eligibility is limited income and financial resources, a criterion which plays no role in determining Medicare coverage. Medicaid covers a wider range of health care services than Medicare. Some people are eligible for both Medicaid and Medicare and are known as <a href="/wiki/Medicare_dual_eligible" title="Medicare dual eligible">Medicare dual eligible</a> or medi-medi's.<a href="#cite_note-63">[63]</a><a href="#cite_note-64">[64]</a> In 2001, about 6.5 million people were enrolled in both Medicare and Medicaid. In 2013, approximately 9 million people qualified for Medicare and Medicaid.<a href="#cite_note-65">[65]</a> <div class="mw-heading mw-heading2"><h2 id="Benefits">Benefits</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=11" title="Edit section: Benefits">edit</a>]</div> There are two general types of Medicaid coverage. "Community Medicaid" helps people who have little or no medical insurance. Medicaid <a href="/wiki/Nursing_home" title="Nursing home">nursing home</a> coverage helps pay for the cost of living in a nursing home for those who are eligible; the recipient also pays most of his/her income toward the nursing home costs, usually keeping only $66.00 a month for expenses other than the nursing home.<a href="#cite_note-:12-66">[66]</a> Some states operate a program known as the <a href="/wiki/Health_Insurance_Premium_Payment_Program" title="Health Insurance Premium Payment Program">Health Insurance Premium Payment Program</a> (HIPP). This program allows a Medicaid recipient to have private health insurance paid for by Medicaid. As of 2008 relatively few states had premium assistance programs and enrollment was relatively low. Interest in this approach remained high, however.<a href="#cite_note-:12-66">[66]</a> Included in the Social Security program under Medicaid are <a href="/wiki/Dentistry" title="Dentistry">dental services</a>. Registration for dental services is optional for people older than 21 years but required for people eligible for Medicaid and younger than 21.<a href="#cite_note-autogenerated2-67">[67]</a> Minimum services include pain relief, <a href="/wiki/Dental_restoration" title="Dental restoration">restoration of teeth</a> and maintenance for dental health. <a href="/wiki/EPSDT" title="EPSDT">Early and Periodic Screening, Diagnostic and Treatment</a> (EPSDT) is a mandatory Medicaid program for children that focuses on prevention, early diagnosis and treatment of medical conditions.<a href="#cite_note-autogenerated2-67">[67]</a> Oral screenings are not required for EPSDT recipients, and they do not suffice as a direct dental referral. If a condition requiring treatment is discovered during an oral screening, the state is responsible for paying for this service, regardless of whether or not it is covered on that particular Medicaid plan.<a href="#cite_note-68">[68]</a> <div class="mw-heading mw-heading3"><h3 id="Dental">Dental</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=12" title="Edit section: Dental">edit</a>]</div> Children enrolled in Medicaid are individually entitled under the law to comprehensive preventive and restorative dental services, but dental care utilization for this population is low. The reasons for low use are many, but a lack of dental providers who participate in Medicaid is a key factor.<a href="#cite_note-69">[69]</a><a href="#cite_note-70">[70]</a> Few dentists participate in Medicaid – less than half of all active private dentists in some areas.<a href="#cite_note-71">[71]</a> Cited reasons for not participating are low reimbursement rates, complex forms and burdensome administrative requirements.<a href="#cite_note-72">[72]</a><a href="#cite_note-73">[73]</a> In Washington state, a program called Access to Baby and Child Dentistry (ABCD) has helped increase access to dental services by providing dentists higher reimbursements for oral health education and preventive and restorative services for children.<a href="#cite_note-74">[74]</a><a href="#cite_note-75">[75]</a> After the passing of the <a href="/wiki/Affordable_Care_Act" title="Affordable Care Act">Affordable Care Act</a>, many <a href="/wiki/Dentistry" title="Dentistry">dental</a> practices began using <a href="/wiki/Dental_Service_Organizations" class="mw-redirect" title="Dental Service Organizations">dental service organizations</a> to provide business management and support, allowing practices to minimize costs and pass the saving on to patients currently without adequate dental care.<a href="#cite_note-76">[76]</a><a href="#cite_note-pacific-77">[77]</a> <div class="mw-heading mw-heading2"><h2 id="Eligibility">Eligibility</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=13" title="Edit section: Eligibility">edit</a>]</div> While Congress and the <a href="/wiki/Centers_for_Medicare_%26_Medicaid_Services" title="Centers for Medicare & Medicaid Services">Centers for Medicare and Medicaid Services</a> (CMS) set out the general rules under which Medicaid operates, each state runs its own program. Under certain circumstances, an applicant may be denied coverage. As a result, the eligibility rules differ significantly from state to state, although all states must follow the same basic framework.<a href="#cite_note-:13-78">[78]</a> As of 2013, Medicaid is a program intended for those with low income, but a low income is not the only requirement to enroll in the program. Eligibility is categorical—that is, to enroll one must be a member of a category defined by statute; some of these categories are: low-income children below a certain wage, pregnant women, parents of Medicaid-eligible children who meet certain income requirements, low-income disabled people who receive Supplemental Security Income (SSI) and/or <a href="/wiki/Social_Security_Disability" class="mw-redirect" title="Social Security Disability">Social Security Disability</a> (SSD), and low-income seniors 65 and older. The details of how each category is defined vary from state to state.<a href="#cite_note-:13-78">[78]</a> <div class="mw-heading mw-heading3"><h3 id="PPACA_income_test_standardization">PPACA income test standardization</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=14" title="Edit section: PPACA income test standardization">edit</a>]</div> As of 2019, when Medicaid has been expanded under the PPACA, eligibility is determined by an income test using <a href="/wiki/Adjusted_gross_income" title="Adjusted gross income">Modified Adjusted Gross Income</a>, with no state-specific variations and a prohibition on asset or resource tests.<a href="#cite_note-:6-79">[79]</a> <div class="mw-heading mw-heading3"><h3 id="Non-PPACA_eligibility">Non-PPACA eligibility</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=15" title="Edit section: Non-PPACA eligibility">edit</a>]</div> While Medicaid expansion available to adults under the PPACA mandates a standard income-based test without asset or resource tests, other eligibility criteria such as assets may apply when eligible outside of the PPACA expansion,<a href="#cite_note-:6-79">[79]</a> including coverage for eligible seniors or disabled.<a href="#cite_note-80">[80]</a> These other requirements include, but are not limited to, assets, age, pregnancy, disability,<a href="#cite_note-81">[81]</a> blindness, income, and resources, and one's status as a <a href="/wiki/Citizenship_of_the_United_States" title="Citizenship of the United States">U.S. citizen</a> or a <a href="/wiki/Us_resident" class="mw-redirect" title="Us resident">lawfully admitted immigrant</a>.<a href="#cite_note-:4-2">[2]</a> As of 2015, asset tests varied; for example, eight states did not have an asset test for a buy-in available to working people with disabilities, and one state had no asset test for the aged/blind/disabled pathway up to 100% of the <a href="/wiki/Federal_poverty_level" class="mw-redirect" title="Federal poverty level">Federal Poverty Level</a>.<a href="#cite_note-82">[82]</a> More recently, many states have authorized financial requirements that will make it more difficult for working-poor adults to access coverage. In <a href="/wiki/Wisconsin" title="Wisconsin">Wisconsin</a>, nearly a quarter of Medicaid patients were dropped after the state government imposed premiums of 3% of household income.<a href="#cite_note-:5-83">[83]</a> A survey in <a href="/wiki/Minnesota" title="Minnesota">Minnesota</a> found that more than half of those covered by Medicaid were unable to obtain prescription medications because of <a href="/wiki/Copayment" title="Copayment">co-payments</a>.<a href="#cite_note-:5-83">[83]</a> The <a href="/wiki/Deficit_Reduction_Act_of_2005" title="Deficit Reduction Act of 2005">Deficit Reduction Act of 2005</a> (DRA) requires anyone seeking Medicaid to produce documents to prove that he is a United States citizen or resident alien. An exception is made for Emergency Medicaid where payments are allowed for the pregnant and disabled regardless of immigration status.<a href="#cite_note-84">[84]</a> Special rules exist for those living in a nursing home and disabled children living at home. <div class="mw-heading mw-heading4"><h4 id="Supplemental_Security_Income_beneficiaries">Supplemental Security Income beneficiaries</h4>[<a href="/w/index.php?title=Medicaid&action=edit&section=16" title="Edit section: Supplemental Security Income beneficiaries">edit</a>]</div> Once someone is approved as a beneficiary in the <a href="/wiki/Supplemental_Security_Income" title="Supplemental Security Income">Supplemental Security Income</a> program, they may automatically be eligible for Medicaid coverage (depending on the laws of the state they reside in).<a href="#cite_note-85">[85]</a> <div class="mw-heading mw-heading4"><h4 id="Five_year_"look-back"">Five year "look-back"</h4>[<a href="/w/index.php?title=Medicaid&action=edit&section=17" title="Edit section: Five year "look-back"">edit</a>]</div> The DRA has created a five-year "look-back period". This means that any transfers without fair market value (gifts of any kind) made by the Medicaid applicant during the preceding five years are penalizable. The penalty is determined by dividing the average monthly cost of nursing home care in the area or State into the amount of assets gifted. Therefore, if a person gifted $60,000 and the average monthly cost of a nursing home was $6,000, one would divide $6000 into $60,000 and come up with 10. 10 represents the number of months the applicant would not be eligible for Medicaid. All transfers made during the five-year look-back period are totaled, and the applicant is penalized based on that amount after having already dropped below the Medicaid asset limit. This means that after dropping below the asset level ($2,000 limit in most states), the Medicaid applicant will be ineligible for a period of time. The penalty period does not begin until the person is eligible for Medicaid.<a href="#cite_note-86">[86]</a> Elders who gift or transfer assets can be caught in the situation of having no money but still not being eligible for Medicaid. <div class="mw-heading mw-heading4"><h4 id="Immigration_status">Immigration status</h4>[<a href="/w/index.php?title=Medicaid&action=edit&section=18" title="Edit section: Immigration status">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Immigration_to_the_United_States" title="Immigration to the United States">Immigration to the United States</a></div> Legal permanent residents (LPRs) with a substantial work history (defined as 40 quarters of Social Security covered earnings) or military connection are eligible for the full range of major federal means-tested benefit programs, including Medicaid (Medi-Cal).<a href="#cite_note-RL33809-87">[87]</a> LPRs entering after August 22, 1996, are barred from Medicaid for five years, after which their coverage becomes a state option, and states have the option to cover LPRs who are children or who are pregnant during the first five years. Noncitizen SSI recipients are eligible for (and required to be covered under) Medicaid. Refugees and asylees are eligible for Medicaid for seven years after arrival; after this term, they may be eligible at state option. Nonimmigrants and unauthorized aliens are not eligible for most federal benefits, regardless of whether they are means tested, with notable exceptions for emergency services (e.g., Medicaid for emergency medical care), but states have the option to cover nonimmigrant and unauthorized aliens who are pregnant or who are children, and can meet the definition of "lawfully residing" in the United States. Special rules apply to several limited noncitizen categories: certain "cross-border" <a href="/wiki/Native_Americans_in_the_United_States" title="Native Americans in the United States">American Indians</a>, <a href="/wiki/Hmong_people" title="Hmong people">Hmong</a>/Highland Laotians, <a href="/wiki/Parole" title="Parole">parolees</a> and conditional entrants, and cases of abuse. Aliens outside the United States who seek to obtain <a href="/wiki/Visa_policy_of_the_United_States" title="Visa policy of the United States">visas</a> at U.S. consulates overseas or admission at U.S. ports of entry are generally denied entry if they are deemed "likely at any time to become a public charge".<a href="#cite_note-R43220-88">[88]</a> Aliens within the United States who seek to adjust their status to that of lawful permanent resident (LPR), or who entered the United States without inspection, are also generally subject to exclusion and <a href="/wiki/Deportation" title="Deportation">deportation</a> on public charge grounds. Similarly, LPRs and other aliens who have been admitted to the United States are removable if they become a public charge within five years after the date of their entry due to causes that preexisted their entry. A 1999 policy letter from immigration officials defined "public charge" and identified which benefits are considered in public charge determinations, and the policy letter underlies current regulations and other guidance on the public charge grounds of inadmissibility and deportability. Collectively, the various sources addressing the meaning of public charge have historically suggested that an alien's receipt of public benefits, per se, is unlikely to result in the alien being deemed to be removable on public charge grounds. <div class="mw-heading mw-heading3"><h3 id="Children_and_SCHIP">Children and SCHIP</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=19" title="Edit section: Children and SCHIP">edit</a>]</div> A child may be eligible for Medicaid regardless of the eligibility status of his parents. Thus, a child may be covered by Medicaid based on his individual status even if his parents are not eligible. Similarly, if a child lives with someone other than a parent, he may still be eligible based on its individual status.<a href="#cite_note-89">[89]</a> One-third of children and over half (59%) of low-income children are insured through Medicaid or <a href="/wiki/SCHIP" class="mw-redirect" title="SCHIP">SCHIP</a>. The insurance provides them with access to preventive and primary services which are used at a much higher rate than for the uninsured, but still below the utilization of privately insured patients. As of 2014, rate of uninsured children was reduced to 6% (5 million children remain uninsured).<a href="#cite_note-90">[90]</a> <div class="mw-heading mw-heading3"><h3 id="HIV">HIV</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=20" title="Edit section: HIV">edit</a>]</div> Medicaid provided the largest portion of federal money spent on health care for people living with <a href="/wiki/HIV" title="HIV">HIV</a>/AIDS until the implementation of Medicare Part D, when the cost of prescription drugs for those eligible for both Medicare and Medicaid was shifted to Medicare. Unless low income people who are HIV positive meet some other eligibility category, they are not eligible for Medicaid assistance unless they can qualify under the "disabled" category to receive Medicaid assistance — for example, if they progress to <a href="/wiki/AIDS" class="mw-redirect" title="AIDS">AIDS</a> (<a href="/wiki/T-cell" class="mw-redirect" title="T-cell">T-cell</a> count drops below 200).<a href="#cite_note-91">[91]</a> The Medicaid eligibility policy differs from <a href="/wiki/Journal_of_the_American_Medical_Association" class="mw-redirect" title="Journal of the American Medical Association">Journal of the American Medical Association</a> (JAMA) guidelines, which recommend therapy for all patients with T-cell counts of 350 or less and even certain patients with a higher T-cell count. Due to the high costs associated with HIV medications, many patients are not able to begin <a href="/wiki/Antiretroviral" class="mw-redirect" title="Antiretroviral">antiretroviral</a> treatment without Medicaid help. It is estimated that more than half of people living with AIDS in the United States receive Medicaid payments. Two other programs that provide financial assistance to people living with HIV/AIDS are the Social Security Disability Insurance (SSDI) and the Supplemental Security Income programs.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] <div class="mw-heading mw-heading2"><h2 id="Utilization">Utilization</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=21" title="Edit section: Utilization">edit</a>]</div> During 2003–2012, the share of hospital stays billed to Medicaid increased by 2.5%, or 0.8 million stays.<a href="#cite_note-92">[92]</a> As of 2019, Medicaid paid for half of all births in the United States.<a href="#cite_note-Franco-4">[4]</a> Medicaid super utilizers (defined as Medicaid patients with four or more admissions in one year) account for more hospital stays (5.9 vs.1.3 stays), longer lengths of stay (6.1 vs. 4.5 days), and higher hospital costs per stay ($11,766 vs. $9,032).<a href="#cite_note-Characteristics_of_Hospital_Stays-93">[93]</a> Medicaid super-utilizers were more likely than other Medicaid patients to be male and to be aged 45–64 years.<a href="#cite_note-Characteristics_of_Hospital_Stays-93">[93]</a> Common conditions among super-utilizers include <a href="/wiki/Mood_disorder" title="Mood disorder">mood disorders</a> and <a href="/wiki/Mental_disorder" title="Mental disorder">psychiatric disorders</a>, as well as <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes</a>, <a href="/wiki/Cancer" title="Cancer">cancer</a> treatment, <a href="/wiki/Sickle_cell_anemia" class="mw-redirect" title="Sickle cell anemia">sickle cell anemia</a>, <a href="/wiki/Sepsis" title="Sepsis">sepsis</a>, <a href="/wiki/Congestive_heart_failure" class="mw-redirect" title="Congestive heart failure">congestive heart failure</a>, <a href="/wiki/Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">chronic obstructive pulmonary disease</a>, and complications of devices, implants, and <a href="/wiki/Graft_(surgery)" title="Graft (surgery)">grafts</a>.<a href="#cite_note-Characteristics_of_Hospital_Stays-93">[93]</a> <div class="mw-heading mw-heading2"><h2 id="Budget_and_financing">Budget and financing</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=22" title="Edit section: Budget and financing">edit</a>]</div> <figure class="mw-halign-none" typeof="mw:File/Thumb"><a href="/wiki/File:U.S._healthcare_GDP.gif" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/91/U.S._healthcare_GDP.gif/603px-U.S._healthcare_GDP.gif" decoding="async" width="603" height="230" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/9/91/U.S._healthcare_GDP.gif 1.5x" data-file-width="671" data-file-height="256" /></a><figcaption>Medicaid spending as part of total <a href="/wiki/Health_care_in_the_United_States" class="mw-redirect" title="Health care in the United States">U.S. healthcare</a> spending (public and private). Percent of <a href="/wiki/Gross_domestic_product" title="Gross domestic product">gross domestic product</a> (GDP). <a href="/wiki/Congressional_Budget_Office" title="Congressional Budget Office">Congressional Budget Office</a> chart.<a href="#cite_note-94">[94]</a></figcaption></figure> Unlike Medicare, which is solely a federal program, Medicaid is a joint federal-state program. Each state administers its own Medicaid system that must conform to federal guidelines for the state to receive Federal <a href="/wiki/Matching_funds" title="Matching funds">matching funds</a>. Financing of Medicaid in the <a href="/wiki/American_Samoa" title="American Samoa">American Samoa</a>, <a href="/wiki/Puerto_Rico" title="Puerto Rico">Puerto Rico</a>, <a href="/wiki/Guam" title="Guam">Guam</a>, and the <a href="/wiki/United_States_Virgin_Islands" title="United States Virgin Islands">U.S. Virgin Islands</a> is instead implemented through a <a href="/wiki/Block_grant_(United_States)" class="mw-redirect" title="Block grant (United States)">block grant</a>.<a href="#cite_note-95">[95]</a> The Federal government matches state funding according to the <a href="/wiki/Federal_Medical_Assistance_Percentages" title="Federal Medical Assistance Percentages">Federal Medical Assistance Percentages</a>.<a href="#cite_note-96">[96]</a> The wealthiest states only receive a federal match of 50% while poorer states receive a larger match.<a href="#cite_note-97">[97]</a> Medicaid funding has become a major budgetary issue for many states over the last few years, with states, on average, spending 16.8% of state general funds on the program. If the federal match expenditure is also counted, the program, on average, takes up 22% of each state's budget.<a href="#cite_note-98">[98]</a><a href="#cite_note-99">[99]</a> Some 43 million Americans were enrolled in 2004 (19.7 million of them children) at a total cost of $295 billion.<a href="#cite_note-100">[100]</a> In 2008, Medicaid provided health coverage and services to approximately 49 million low-income children, pregnant women, elderly people, and disabled people.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] Federal Medicaid outlays were estimated to be $204 billion in 2008.<a href="#cite_note-101">[101]</a> In 2011, there were 7.6 million hospital stays billed to Medicaid, representing 15.6% (approximately $60.2 billion) of total aggregate inpatient hospital costs in the United States.<a href="#cite_note-102">[102]</a> At $8,000, the mean cost per stay billed to Medicaid was $2,000 less than the average cost for all stays.<a href="#cite_note-103">[103]</a> Medicaid does not pay benefits to individuals directly; Medicaid sends benefit payments to health care providers. In some states Medicaid beneficiaries are required to pay a small fee (co-payment) for medical services.<a href="#cite_note-:4-2">[2]</a> Medicaid is limited by federal law to the coverage of "medically necessary services".<a href="#cite_note-Adler-104">[104]</a> Since the Medicaid program was established in 1965, "states have been permitted to recover from the estates of deceased Medicaid recipients who were over age 65 when they received benefits and who had no surviving spouse, minor child, or adult disabled child".<a href="#cite_note-Kiely-105">[105]</a> In 1993, Congress enacted the <a href="/wiki/Omnibus_Budget_Reconciliation_Act_of_1993" title="Omnibus Budget Reconciliation Act of 1993">Omnibus Budget Reconciliation Act of 1993</a>, which required states to attempt to recoup "the expense of long-term care and related costs for deceased Medicaid recipients 55 or older."<a href="#cite_note-Kiely-105">[105]</a> The Act allowed states to recover other Medicaid expenses for deceased Medicaid recipients 55 or older, at each state's choice.<a href="#cite_note-Kiely-105">[105]</a> However, states were prohibited from estate recovery when "there is a surviving spouse, a child under the age of 21 or a child of any age who is blind or disabled". The Act also carved out other exceptions for adult children who have served as caretakers in the homes of the deceased, property owned jointly by siblings, and income-producing property, such as farms".<a href="#cite_note-Kiely-105">[105]</a> Each state now maintains a <a href="/wiki/Medicaid_Estate_Recovery_Program" title="Medicaid Estate Recovery Program">Medicaid Estate Recovery Program</a>, although the sum of money collected significantly varies from state to state, "depending on how the state structures its program and how vigorously it pursues collections."<a href="#cite_note-Kiely-105">[105]</a> On November 25, 2008, a new federal rule was passed that allows states to charge premiums and higher co-payments to Medicaid participants.<a href="#cite_note-106">[106]</a> This rule enabled states to take in greater revenues, limiting financial losses associated with the program. Estimates figure that states will save $1.1 billion while the federal government will save nearly $1.4 billion. However, this meant that the burden of financial responsibility would be placed on 13 million Medicaid recipients who faced a $1.3 billion increase in co-payments over 5 years.<a href="#cite_note-107">[107]</a> The major concern is that this rule will create a disincentive for low-income people to seek healthcare. It is possible that this will force only the sickest participants to pay the increased premiums and it is unclear what long-term effect this will have on the program. A 2019 study found that Medicaid expansion in <a href="/wiki/Michigan" title="Michigan">Michigan</a> had net positive fiscal effects for the state.<a href="#cite_note-108">[108]</a> <div class="mw-heading mw-heading2"><h2 id="Effects">Effects</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=23" title="Edit section: Effects">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Coverage_gains">Coverage gains</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=24" title="Edit section: Coverage gains">edit</a>]</div> A 2019 review by Kaiser Family Foundation of 324 studies on Medicaid expansion concluded that "expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers."<a href="#cite_note-:7-11">[11]</a> <div class="mw-heading mw-heading3"><h3 id="Mortality_and_disability_reduction">Mortality and disability reduction</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=25" title="Edit section: Mortality and disability reduction">edit</a>]</div> A 2021 study found that Medicaid expansion as part of the Affordable Care Act led to a substantial reduction in mortality, primarily driven by reductions in disease-related deaths.<a href="#cite_note-:8-13">[13]</a> A 2018 study in the <a href="/wiki/Journal_of_Political_Economy" title="Journal of Political Economy">Journal of Political Economy</a> found that upon its introduction, Medicaid reduced infant and child mortality in the 1960s and 1970s.<a href="#cite_note-:2-109">[109]</a> The decline in the mortality rate for nonwhite children was particularly steep.<a href="#cite_note-:2-109">[109]</a> A 2018 study in the American Journal of Public Health found that the infant mortality rate declined in states that had Medicaid expansions (as part of the Affordable Care Act) whereas the rate rose in states that declined Medicaid expansion.<a href="#cite_note-110">[110]</a> A 2020 JAMA study found that Medicaid expansion under the ACA was associated with reduced incidence of advanced-stage breast cancer, indicating that Medicaid accessibility led to early detection of breast cancer and higher survival rates.<a href="#cite_note-111">[111]</a> A 2020 study found no evidence that Medicaid expansion adversely affected the quality of health care given to Medicare recipients.<a href="#cite_note-112">[112]</a> A 2018 study found that Medicaid expansions in <a href="/wiki/New_York_(state)" title="New York (state)">New York</a>, Arizona, and Maine in the early 2000s caused a 6% decline in the mortality rate: "HIV-related mortality (affected by the recent introduction of antiretrovirals) accounted for 20% of the effect. Mortality changes were closely linked to county-level coverage gains, with one life saved annually for every 239 to 316 adults gaining insurance. The results imply a cost per life saved ranging from $327,000 to $867,000 which compares favorably with most estimates of the value of a statistical life."<a href="#cite_note-113">[113]</a> A 2016 paper found that Medicaid has substantial positive long-term effects on the health of recipients: "Early childhood Medicaid eligibility reduces mortality and disability and, for whites, increases extensive margin labor supply, and reduces receipt of disability transfer programs and public health insurance up to 50 years later. Total income does not change because earnings replace disability benefits."<a href="#cite_note-:0-114">[114]</a> The government recoups its investment in Medicaid through savings on benefit payments later in life and greater payment of taxes because recipients of Medicaid are healthier: "The government earns a discounted annual return of between 2% and 7% on the original cost of childhood coverage for these cohorts, most of which comes from lower cash transfer payments".<a href="#cite_note-:0-114">[114]</a> A 2019 <a href="/wiki/National_Bureau_of_Economic_Research" title="National Bureau of Economic Research">National Bureau of Economic Research</a> paper found that when <a href="/wiki/Hawaii" title="Hawaii">Hawaii</a> stopped allowing <a href="/wiki/Compact_of_Free_Association" title="Compact of Free Association">Compact of Free Association (COFA)</a> migrants to be covered by the state's Medicaid program that Medicaid-funded hospitalizations declined by 69% and emergency room visits declined by 42% for this population, but that uninsured ER visits increased and that Medicaid-funded ER visits by infants substantially increased.<a href="#cite_note-115">[115]</a> Another NBER paper found that Medicaid expansion reduced mortality.<a href="#cite_note-116">[116]</a> A 2021 American Economic Review study found that early childhood access to Medicaid "reduces mortality and disability, increases employment, and reduces receipt of disability transfer programs up to 50 years later. Medicaid has saved the government more than its original cost and saved more than 10 million quality adjusted life years."<a href="#cite_note-117">[117]</a> <div class="mw-heading mw-heading3"><h3 id="Rural_hospitals_boosted_revenue">Rural hospitals boosted revenue</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=26" title="Edit section: Rural hospitals boosted revenue">edit</a>]</div> A 2020 study found that Medicaid expansion boosted the revenue and operating margins of rural hospitals, had no impact on small urban hospitals, and led to declines in revenue for large urban hospitals.<a href="#cite_note-118">[118]</a> A 2021 study found that expansions of adult Medicaid dental coverage increasingly led dentists to locate to poor, previously underserved areas.<a href="#cite_note-119">[119]</a> A 2019 paper by <a href="/wiki/Stanford_University" title="Stanford University">Stanford University</a> and <a href="/wiki/Wharton_School" title="Wharton School">Wharton School</a> economists found that Medicaid expansion "produced a substantial increase in hospital revenue and profitability, with larger gains for government hospitals. On the benefits side, we do not detect significant improvements in patient health, although the expansion led to substantially greater hospital and emergency room use, and a reallocation of care from public to private and better-quality hospitals."<a href="#cite_note-120">[120]</a> <div class="mw-heading mw-heading3"><h3 id="Financial_and_health_security_increase">Financial and health security increase</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=27" title="Edit section: Financial and health security increase">edit</a>]</div> A 2017 survey of the academic research on Medicaid found it improved recipients' health and financial security.<a href="#cite_note-:1-10">[10]</a> Studies have linked Medicaid expansion with increases in employment levels and student status among enrollees.<a href="#cite_note-121">[121]</a><a href="#cite_note-122">[122]</a><a href="#cite_note-123">[123]</a> A 2017 paper found that Medicaid expansion under the Affordable Care Act "reduced unpaid medical bills sent to collection by $3.4 billion in its first two years, prevented new delinquencies, and improved <a href="/wiki/Credit_score" title="Credit score">credit scores</a>. Using data on credit offers and pricing, we document that improvements in households' financial health led to better terms for available credit valued at $520 million per year. We calculate that the financial benefits of Medicaid double when considering these indirect benefits in addition to the direct reduction in out-of-pocket expenditures."<a href="#cite_note-124">[124]</a> Studies have found that Medicaid expansion reduced rates of poverty and severe <a href="/wiki/Food_security" title="Food security">food insecurity</a> in certain states.<a href="#cite_note-125">[125]</a><a href="#cite_note-126">[126]</a> Studies on the implementation of work requirements for Medicaid in Arkansas found that it led to an increase in uninsured individuals, medical debt, and delays in seeking care and taking medications, without any significant impact on employment.<a href="#cite_note-127">[127]</a><a href="#cite_note-128">[128]</a><a href="#cite_note-129">[129]</a> A 2021 study in the American Journal of Public Health found that Medicaid expansion in Louisiana led to reductions in <a href="/wiki/Medical_debt" title="Medical debt">medical debt</a>.<a href="#cite_note-130">[130]</a> <div class="mw-heading mw-heading3"><h3 id="Political_participation_increase">Political participation increase</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=28" title="Edit section: Political participation increase">edit</a>]</div> A 2017 study found that Medicaid enrollment increases political participation (measured in terms of voter registration and turnout).<a href="#cite_note-131">[131]</a> <div class="mw-heading mw-heading3"><h3 id="Crime_reduction">Crime reduction</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=29" title="Edit section: Crime reduction">edit</a>]</div> Studies have found that Medicaid expansion reduced crime. The proposed mechanisms for the reduction were that Medicaid increased the economic security of individuals and provided greater access to <a href="/wiki/Substance_abuse_prevention" title="Substance abuse prevention">treatment for substance abuse</a> or <a href="/wiki/Behavioral_disorder" class="mw-redirect" title="Behavioral disorder">behavioral disorders</a>.<a href="#cite_note-132">[132]</a><a href="#cite_note-133">[133]</a> A 2022 study found that Medicaid eligibility during childhood reduced the likelihood of criminality during early adulthood.<a href="#cite_note-134">[134]</a> <div class="mw-heading mw-heading3"><h3 id="Oregon_Medicaid_health_experiment_and_controversy">Oregon Medicaid health experiment and controversy</h3>[<a href="/w/index.php?title=Medicaid&action=edit&section=30" title="Edit section: Oregon Medicaid health experiment and controversy">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Oregon_Medicaid_health_experiment" title="Oregon Medicaid health experiment">Oregon Medicaid health experiment</a></div> In 2008, Oregon decided to hold a randomized lottery for the provision of Medicaid insurance in which 10,000 lower-income people eligible for Medicaid were chosen by a randomized system. The lottery enabled studies to accurately measure the impact of health insurance on an individual's health and eliminate potential selection bias in the population enrolling in Medicaid. A sequence of two high-profile studies by a team from the <a href="/wiki/Massachusetts_Institute_of_Technology" title="Massachusetts Institute of Technology">Massachusetts Institute of Technology</a> and the <a href="/wiki/Harvard_School_of_Public_Health" class="mw-redirect" title="Harvard School of Public Health">Harvard School of Public Health</a><a href="#cite_note-135">[135]</a> found that "Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years", but did "increase use of health care services, raise rates of diabetes detection and management, lower rates of <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a>, and reduce financial strain." The study found that in the first year:<a href="#cite_note-136">[136]</a> <ol><li>Hospital use increased by 30% for those with insurance, with the length of hospital stays increasing by 30% and the number of procedures increasing by 45% for the population with insurance;</li> <li>Medicaid recipients proved more likely to seek preventive care. Women were 60% more likely to have <a href="/wiki/Mammography" title="Mammography">mammograms</a> and recipients overall were 20% more likely to have their <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a> checked;</li> <li>In terms of self-reported health outcomes, having insurance was associated with an increased probability of reporting one's health as "good", "very good", or "excellent"—overall, about 25% higher than the average;</li> <li>Those with insurance were about 10% less likely to report a diagnosis of depression.</li> <li>Patients with catastrophic health spending (with costs that were greater than 30% of income) dropped.</li> <li>Medicaid patients had cut in half the probability of requiring loans or forgoing other bills to pay for medical costs.<a href="#cite_note-137">[137]</a></li></ol> The studies spurred a debate between proponents of expanding Medicaid coverage and fiscal conservatives challenging the value of this expansive government program.<a href="#cite_note-138">[138]</a><a href="#cite_note-139">[139]</a> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=31" title="Edit section: See also">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239009302">.mw-parser-output .portalbox{padding:0;margin:0.5em 0;display:table;box-sizing:border-box;max-width:175px;list-style:none}.mw-parser-output .portalborder{border:1px solid var(--border-color-base,#a2a9b1);padding:0.1em;background:var(--background-color-neutral-subtle,#f8f9fa)}.mw-parser-output .portalbox-entry{display:table-row;font-size:85%;line-height:110%;height:1.9em;font-style:italic;font-weight:bold}.mw-parser-output .portalbox-image{display:table-cell;padding:0.2em;vertical-align:middle;text-align:center}.mw-parser-output .portalbox-link{display:table-cell;padding:0.2em 0.2em 0.2em 0.3em;vertical-align:middle}@media(min-width:720px){.mw-parser-output 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Waivers">Medicaid Home and Community-Based Services Waivers</a></li> <li><a href="/wiki/Medicare_for_All_Act" title="Medicare for All Act">Medicare for All Act</a></li> <li><a href="/wiki/State_Children%27s_Health_Insurance_Program" class="mw-redirect" title="State Children's Health Insurance Program">State Children's Health Insurance Program</a> (SCHIP/CHIP)</li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=32" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><a href="#cite_ref-1">^</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free 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New England Journal of Medicine. 368 (18): 1713–1722. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMsa1212321">10.1056/NEJMsa1212321</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0028-4793">0028-4793</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3701298">3701298</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23635051">23635051</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=New+England+Journal+of+Medicine&rft.atitle=The+Oregon+Experiment+%E2%80%94+Effects+of+Medicaid+on+Clinical+Outcomes&rft.volume=368&rft.issue=18&rft.pages=1713-1722&rft.date=2013-05-02&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3701298%23id-name%3DPMC&rft.issn=0028-4793&rft_id=info%3Apmid%2F23635051&rft_id=info%3Adoi%2F10.1056%2FNEJMsa1212321&rft.aulast=Baicker&rft.aufirst=Katherine&rft.au=Taubman%2C+Sarah+L.&rft.au=Allen%2C+Heidi+L.&rft.au=Bernstein%2C+Mira&rft.au=Gruber%2C+Jonathan+H.&rft.au=Newhouse%2C+Joseph+P.&rft.au=Schneider%2C+Eric+C.&rft.au=Wright%2C+Bill+J.&rft.au=Zaslavsky%2C+Alan+M.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3701298&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMedicaid" class="Z3988"> </li> <li id="cite_note-136"><a href="#cite_ref-136">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFOlver2011" class="citation web cs1">Olver, Christopher (July 11, 2011). <a rel="nofollow" class="external text" href="http://journalistsresource.org/studies/society/health/oregon-health-insurance-experiment/">"Oregon Health Insurance Experiment: Evidence from the First Year"</a>. journalistsresource.org.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=journalistsresource.org&rft.atitle=Oregon+Health+Insurance+Experiment%3A+Evidence+from+the+First+Year&rft.date=2011-07-11&rft.aulast=Olver&rft.aufirst=Christopher&rft_id=http%3A%2F%2Fjournalistsresource.org%2Fstudies%2Fsociety%2Fhealth%2Foregon-health-insurance-experiment%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMedicaid" class="Z3988"> </li> <li id="cite_note-137"><a href="#cite_ref-137">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://www.economist.com/blogs/democracyinamerica/2013/05/medicaid">"More study needed"</a>. The Economist. May 6, 2013. Retrieved June 27, 2017.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Economist&rft.atitle=More+study+needed&rft.date=2013-05-06&rft_id=https%3A%2F%2Fwww.economist.com%2Fblogs%2Fdemocracyinamerica%2F2013%2F05%2Fmedicaid&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMedicaid" class="Z3988"> </li> <li id="cite_note-138"><a href="#cite_ref-138">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFung2012" class="citation web cs1">Fung, Brian (June 26, 2012). <a rel="nofollow" class="external text" href="https://www.theatlantic.com/health/archive/2012/06/what-actually-happens-when-you-expand-medicaid-as-obamacare-does/258989/">"What Actually Happens When You Expand Medicaid, as Obamacare Does?"</a>. The Atlantic. Retrieved April 18, 2019.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=The+Atlantic&rft.atitle=What+Actually+Happens+When+You+Expand+Medicaid%2C+as+Obamacare+Does%3F&rft.date=2012-06-26&rft.aulast=Fung&rft.aufirst=Brian&rft_id=https%3A%2F%2Fwww.theatlantic.com%2Fhealth%2Farchive%2F2012%2F06%2Fwhat-actually-happens-when-you-expand-medicaid-as-obamacare-does%2F258989%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMedicaid" class="Z3988"> </li> <li id="cite_note-139"><a href="#cite_ref-139">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRoy" class="citation web cs1">Roy, Avik. <a rel="nofollow" class="external text" href="https://www.forbes.com/sites/theapothecary/2013/05/02/oregon-study-medicaid-had-no-significant-effect-on-health-outcomes-vs-being-uninsured/">"Oregon Study: Medicaid 'Had No Significant Effect' On Health Outcomes vs. Being Uninsured"</a>. Forbes. Retrieved April 18, 2019.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Forbes&rft.atitle=Oregon+Study%3A+Medicaid+%27Had+No+Significant+Effect%27+On+Health+Outcomes+vs.+Being+Uninsured&rft.aulast=Roy&rft.aufirst=Avik&rft_id=https%3A%2F%2Fwww.forbes.com%2Fsites%2Ftheapothecary%2F2013%2F05%2F02%2Foregon-study-medicaid-had-no-significant-effect-on-health-outcomes-vs-being-uninsured%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMedicaid" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=33" title="Edit section: Further reading">edit</a>]</div> <ul><li><a href="/wiki/House_Ways_and_Means_Committee" class="mw-redirect" title="House Ways and Means Committee">House Ways and Means Committee</a>, <a rel="nofollow" class="external text" href="https://www.oregonadvocates.org/geo/search/attachment.62016">2004 Green Book – Overview of the Medicaid Program</a>, United States House of Representatives, 2004.</li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Medicaid&action=edit&section=34" title="Edit section: External links">edit</a>]</div> <ul><li><a rel="nofollow" class="external text" href="https://cms.hhs.gov/">CMS official web site</a> <ul><li><a rel="nofollow" class="external text" href="http://www.medicaid.gov/">Medicaid information</a> <ul><li><a rel="nofollow" class="external text" href="https://www.healthcare.gov/">Healthcare information for consumers</a></li> <li><a rel="nofollow" class="external text" href="http://www.insurekidsnow.gov/">Insurance information for consumers</a></li></ul></li></ul></li> <li><a rel="nofollow" class="external text" href="https://www.govinfo.gov/content/pkg/COMPS-8765/uslm/COMPS-8765.xml">Social Security Act - Title XIX Grants to States for Medical Assistance Programs</a> (<a rel="nofollow" class="external text" href="https://www.govinfo.gov/content/pkg/COMPS-8765/pdf/COMPS-8765.pdf">PDF</a>/<a rel="nofollow" class="external text" href="https://www.govinfo.gov/app/details/COMPS-8765/">details</a>) as amended in the <a href="/wiki/United_States_Government_Publishing_Office" title="United States Government Publishing Office">GPO</a> <a rel="nofollow" class="external text" href="https://www.govinfo.gov/help/comps">Statute Compilations collection</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20120107012004/http://www.hapnetwork.org/ship-locator/">Health Assistance Partnership</a></li> <li><a rel="nofollow" class="external text" href="https://aspe.hhs.gov/health/reports/06/trendsinmedicaid/report.pdf">Trends in Medicaid, October 2006.</a> Staff Paper of the Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services</li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20080415185952/http://digital.library.unt.edu/govdocs/crs/search.tkl?q=medicaid&search_crit=fulltext&search=Search&date1=Anytime&date2=Anytime&type=form">Read Congressional Research Service (CRS) Reports regarding Medicaid</a></li> <li><a rel="nofollow" class="external text" href="http://ccf.georgetown.edu/index/federal-medicaid-policy">"Medicaid Research"</a> and <a rel="nofollow" class="external text" href="http://ccf.georgetown.edu/index/about-medicaid">"Medicaid Primer"</a> from Georgetown University Center for Children and Families.</li> <li><a rel="nofollow" class="external text" href="http://www.kff.org/medicaid/">KFF (formerly Kaiser Family Foundation)</a> – Substantial resources on Medicaid including federal eligibility requirements, benefits, financing and administration. <ul><li><a rel="nofollow" class="external text" href="http://kff.org/medicaid/issue-brief/the-role-of-medicaid-in-state-economies-and-the-aca/">"The Role of Medicaid in State Economies: A Look at the Research,"</a> <a href="/wiki/Kaiser_Family_Foundation" title="Kaiser Family Foundation">Kaiser Family Foundation</a>, November 2013</li> <li><a rel="nofollow" class="external text" href="http://kff.org/state-category/medicaid-chip/">State-level data</a> on health care spending, utilization, and insurance coverage, including details extensive Medicaid information.</li> <li><a rel="nofollow" class="external text" href="http://kff.org/medicaid/timeline/medicaid-timeline/">History of Medicaid</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20171003124026/http://kff.org/medicaid/timeline/medicaid-timeline/">Archived</a> October 3, 2017, at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> in an interactive timeline of key developments.</li></ul></li> <li><a rel="nofollow" class="external text" href="http://www.statecoverage.org/coverage">Coverage By State</a> – Information on state health coverage, including Medicaid, by the Robert Wood Johnson Foundation & AcademyHealth.</li> <li><a rel="nofollow" class="external text" href="http://www.familiesusa.org/issues/medicaid/">Medicaid</a> information from <a href="/wiki/Families_USA" title="Families USA">Families USA</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20061008200250/http://www.tcf.org/Publications/HealthCare/medicaidbasics.htm">Medicaid Reform – The Basics</a> from The Century Foundation</li> <li><a rel="nofollow" class="external text" href="http://www.nasmd.org/">National Association of State Medicaid Directors</a> Organization representing the chief executives of state Medicaid programs.</li> <li><a rel="nofollow" class="external text" href="http://www.citizen.org/hrg1807">Ranking of state Medicaid programs by eligibility, scope of services, quality of service and reimbursement</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20170306134122/http://www.citizen.org/hrg1807">Archived</a> March 6, 2017, at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> from Public Citizen. 2007.</li> <li><a rel="nofollow" class="external text" href="http://www.chcs.org/">Center for Health Care Strategies, CHCS</a> Extensive library of tools, briefs, and reports developed to help state agencies, health plans and policymakers improve the quality and cost-effectiveness of Medicaid.</li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output 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Johnson"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Lyndon_B._Johnson" title="Template talk:Lyndon B. Johnson"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Lyndon_B._Johnson" title="Special:EditPage/Template:Lyndon B. Johnson"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Lyndon_B._Johnson" style="font-size:114%;margin:0 4em"><a href="/wiki/Lyndon_B._Johnson" title="Lyndon B. Johnson">Lyndon B. Johnson</a></div></th></tr><tr><td class="navbox-abovebelow" colspan="3"><div> <ul><li><a href="/wiki/List_of_presidents_of_the_United_States" title="List of presidents of the United States">36th</a> <a href="/wiki/President_of_the_United_States" title="President of the United States">President of the United States</a> (1963–1969)</li> <li><a href="/wiki/List_of_vice_presidents_of_the_United_States" title="List of vice presidents of the United States">37th</a> <a href="/wiki/Vice_President_of_the_United_States" title="Vice President of the United States">Vice President of the United States</a> (1961–1963)</li> <li><a href="/wiki/United_States_Senate" title="United States Senate">U.S. Senator</a> from <a href="/wiki/List_of_United_States_senators_from_Texas" title="List of United States senators from Texas">Texas</a> (1949–1961)</li> <li><a href="/wiki/United_States_House_of_Representatives" title="United States House of Representatives">U.S. Representative</a> for <a href="/wiki/Texas%27s_10th_congressional_district" title="Texas's 10th congressional district">TX-10</a> (1937–1949)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Presidency_of_Lyndon_B._Johnson" title="Presidency of Lyndon B. Johnson">Presidency</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Timeline_of_the_Lyndon_B._Johnson_presidency" title="Timeline of the Lyndon B. Johnson presidency">Timeline</a></li> <li>Inaugurations <ul><li><a href="/wiki/First_inauguration_of_Lyndon_B._Johnson" title="First inauguration of Lyndon B. Johnson">first</a></li> <li><a href="/wiki/Second_inauguration_of_Lyndon_B._Johnson" title="Second inauguration of Lyndon B. Johnson">second</a></li></ul></li> <li><a href="/wiki/Let_Us_Continue" title="Let Us Continue">Let Us Continue</a></li> <li><a href="/wiki/Great_Society" title="Great Society">Great Society</a> (<a href="/wiki/Model_Cities_Program" title="Model Cities Program">Model Cities Program</a>)</li> <li><a href="/wiki/Architectural_Barriers_Act_of_1968" title="Architectural Barriers Act of 1968">Architectural Barriers Act</a></li> <li><a href="/wiki/Child_Nutrition_Act" title="Child Nutrition Act">Child Nutrition Act</a></li> <li><a href="/wiki/Clean_Air_Act_(United_States)" title="Clean Air Act (United States)">Clean Air Act</a></li> <li><a href="/wiki/Civil_Rights_Act_of_1964" title="Civil Rights Act of 1964">Civil Rights Act of 1964</a></li> <li><a href="/wiki/Coinage_Act_of_1965" title="Coinage Act of 1965">Coinage Act of 1965</a></li> <li><a href="/wiki/United_States_Department_of_Housing_and_Urban_Development" title="United States Department of Housing and Urban Development">Department of Housing and Urban Development</a></li> <li><a href="/wiki/United_States_Department_of_Transportation" title="United States Department of Transportation">Department of Transportation</a></li> <li><a href="/wiki/Economic_Opportunity_Act_of_1964" title="Economic Opportunity Act of 1964">Economic Opportunity Act of 1964</a> <ul><li><a href="/wiki/Head_Start_Program" class="mw-redirect" title="Head Start Program">Head Start Program</a></li> <li><a href="/wiki/Job_Corps" title="Job Corps">Job Corps</a></li></ul></li> <li><a href="/wiki/Elementary_and_Secondary_Education_Act" title="Elementary and Secondary Education Act">Elementary and Secondary Education Act</a></li> <li><a href="/wiki/Equal_Employment_Opportunity_Commission" title="Equal Employment Opportunity Commission">Equal Employment Opportunity Commission</a></li> <li><a href="/wiki/Civil_Rights_Act_of_1968" title="Civil Rights Act of 1968">Civil Rights Act of 1968</a> <ul><li><a href="/wiki/Fair_Housing_Act" class="mw-redirect" title="Fair Housing Act">Fair Housing Act</a></li></ul></li> <li><a href="/wiki/Truth_in_Lending_Act" title="Truth in Lending Act">Truth in Lending Act</a></li> <li><a href="/wiki/Federal-Aid_Highway_Act_of_1968" title="Federal-Aid Highway Act of 1968">Federal-Aid Highway Act of 1968</a></li> <li><a href="/wiki/Food_Stamp_Act_of_1964" title="Food Stamp Act of 1964">Food Stamp Act of 1964</a></li> <li><a href="/wiki/Glassboro_Summit_Conference" title="Glassboro Summit Conference">Glassboro Summit</a></li> <li><a href="/wiki/Gun_Control_Act_of_1968" title="Gun Control Act of 1968">Gun Control Act of 1968</a></li> <li><a href="/wiki/Higher_Education_Act_of_1965" title="Higher Education Act of 1965">Higher Education Act of 1965</a> <ul><li><a href="/wiki/Upward_Bound" title="Upward Bound">Upward Bound</a></li> <li><a href="/wiki/TRIO_(program)" class="mw-redirect" title="TRIO (program)">TRIO</a></li> <li><a href="/wiki/Teacher_Corps" title="Teacher Corps">Teacher Corps</a></li></ul></li> <li><a href="/wiki/Housing_and_Urban_Development_Act_of_1968" title="Housing and Urban Development Act of 1968">Housing and Urban Development Act of 1968</a></li> <li><a href="/wiki/Immigration_and_Nationality_Act_of_1965" title="Immigration and Nationality Act of 1965">Immigration and Nationality Act of 1965</a></li> <li><a href="/wiki/Johnson_Doctrine" title="Johnson Doctrine">Johnson Doctrine</a> <ul><li><a href="/wiki/United_States_occupation_of_the_Dominican_Republic_(1965%E2%80%9366)" class="mw-redirect" title="United States occupation of the Dominican Republic (1965–66)">Dominican Republic occupation</a></li></ul></li> <li><a href="/wiki/Medicare_(United_States)" title="Medicare (United States)">Medicare</a></li> <li><a class="mw-selflink selflink">Medicaid</a></li> <li><a href="/wiki/Meritorious_Service_Medal_(United_States)#History" title="Meritorious Service Medal (United States)">Meritorious Service Medal</a></li> <li><a href="/wiki/National_Endowment_for_the_Arts" title="National Endowment for the Arts">National Endowment for the Arts</a></li> <li><a href="/wiki/National_Endowment_for_the_Humanities" title="National Endowment for the Humanities">National Endowment for the Humanities</a></li> <li><a href="/wiki/Executive_Order_11246" title="Executive Order 11246">Executive Order 11246</a></li> <li><a href="/wiki/Executive_Order_11375" title="Executive Order 11375">Executive Order 11375</a></li> <li><a href="/wiki/Older_Americans_Act" title="Older Americans Act">Older Americans Act</a></li> <li><a href="/wiki/Operation_CHAOS" title="Operation CHAOS">Operation CHAOS</a></li> <li><a href="/wiki/Outer_Space_Treaty" title="Outer Space Treaty">Outer Space Treaty</a></li> <li><a href="/wiki/Public_Broadcasting_Act_of_1967" title="Public Broadcasting Act of 1967">Public Broadcasting Act of 1967</a></li> <li><a href="/wiki/Foreign_policy_of_the_Lyndon_B._Johnson_administration" title="Foreign policy of the Lyndon B. Johnson administration">Foreign policy</a></li> <li><a href="/wiki/Vietnam_War#Lyndon_B._Johnson's_escalation,_1963–69" title="Vietnam War">Vietnam War</a> <ul><li><a href="/wiki/Gulf_of_Tonkin_Resolution" title="Gulf of Tonkin Resolution">Gulf of Tonkin Resolution</a></li> <li>"<a href="/wiki/Credibility_gap" title="Credibility gap">Credibility gap</a>"</li></ul></li> <li><a href="/wiki/AmeriCorps_VISTA" title="AmeriCorps VISTA">VISTA</a></li> <li><a href="/wiki/Twenty-fourth_Amendment_to_the_United_States_Constitution" title="Twenty-fourth Amendment to the United States Constitution">24th Amendment</a></li> <li><a href="/wiki/Voting_Rights_Act_of_1965" title="Voting Rights Act of 1965">Voting Rights Act of 1965</a></li> <li><a href="/wiki/War_on_poverty" title="War on poverty">War on poverty</a></li> <li><a href="/wiki/White_House_Conference_on_Civil_Rights" title="White House Conference on Civil Rights">White House Conference on Civil Rights</a></li> <li><a href="/wiki/Cannabis_policy_of_the_Lyndon_B._Johnson_administration" title="Cannabis policy of the Lyndon B. Johnson administration">Cannabis policy</a></li> <li><a href="/wiki/Committee_for_the_Preservation_of_the_White_House" title="Committee for the Preservation of the White House">White House preservation</a></li> <li><a href="/wiki/State_of_the_Union" title="State of the Union">State of the Union Address</a> <ul><li><a href="/wiki/1964_State_of_the_Union_Address" title="1964 State of the Union Address">1964</a></li> <li><a href="/wiki/1965_State_of_the_Union_Address" title="1965 State of the Union Address">1965</a></li> <li><a href="/wiki/1966_State_of_the_Union_Address" title="1966 State of the Union Address">1966</a></li> <li><a href="/wiki/1967_State_of_the_Union_Address" title="1967 State of the Union Address">1967</a></li> <li><a href="/wiki/1968_State_of_the_Union_Address" title="1968 State of the Union Address">1968</a></li> <li><a href="/wiki/1969_State_of_the_Union_Address" title="1969 State of the Union Address">1969</a></li></ul></li> <li><a href="/wiki/Lyndon_B._Johnson#Administration_and_Cabinet" title="Lyndon B. Johnson">Cabinet</a></li> <li><a href="/wiki/List_of_federal_judges_appointed_by_Lyndon_B._Johnson" title="List of federal judges appointed by Lyndon B. Johnson">Judicial appointments</a> <ul><li><a href="/wiki/Lyndon_B._Johnson_Supreme_Court_candidates" title="Lyndon B. Johnson Supreme Court candidates">Supreme Court</a></li> <li><a href="/wiki/Thurgood_Marshall_Supreme_Court_nomination" title="Thurgood Marshall Supreme Court nomination">Thurgood Marshall Supreme Court nomination</a></li> <li><a href="/wiki/Lyndon_B._Johnson_judicial_appointment_controversies" title="Lyndon B. Johnson judicial appointment controversies">controversies</a></li></ul></li> <li><a href="/wiki/Johnson_desk" title="Johnson desk">Johnson desk</a></li> <li><a href="/wiki/Presidential_transition_of_Richard_Nixon" title="Presidential transition of Richard Nixon">Presidential transition of Richard Nixon</a></li> <li><a href="https://en.wikisource.org/wiki/Author:Lyndon_Baines_Johnson/Executive_orders" class="extiw" title="wikisource:Author:Lyndon Baines Johnson/Executive orders">Executive Orders</a></li> <li><a href="https://en.wikisource.org/wiki/Author:Lyndon_Baines_Johnson/Presidential_Proclamations" class="extiw" title="wikisource:Author:Lyndon Baines Johnson/Presidential Proclamations">Presidential Proclamations</a></li></ul> </div></td><td class="noviewer navbox-image" rowspan="6" style="width:1px;padding:0 0 0 2px"><div><a href="/wiki/File:37_Lyndon_Johnson_3x4.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c3/37_Lyndon_Johnson_3x4.jpg/100px-37_Lyndon_Johnson_3x4.jpg" decoding="async" width="100" height="133" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c3/37_Lyndon_Johnson_3x4.jpg/150px-37_Lyndon_Johnson_3x4.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c3/37_Lyndon_Johnson_3x4.jpg/200px-37_Lyndon_Johnson_3x4.jpg 2x" data-file-width="924" data-file-height="1228" /></a> <a href="/wiki/File:Seal_of_the_President_of_the_United_States.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/Seal_of_the_President_of_the_United_States.svg/100px-Seal_of_the_President_of_the_United_States.svg.png" decoding="async" width="100" height="100" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/Seal_of_the_President_of_the_United_States.svg/150px-Seal_of_the_President_of_the_United_States.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/36/Seal_of_the_President_of_the_United_States.svg/200px-Seal_of_the_President_of_the_United_States.svg.png 2x" data-file-width="2424" data-file-height="2425" /></a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Life</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lyndon_B._Johnson#Early_years" title="Lyndon B. Johnson">Early years and career</a></li> <li><a href="/wiki/Operation_Texas" title="Operation Texas">Operation Texas</a></li> <li><a href="/wiki/KTBC_(TV)" title="KTBC (TV)">Texas Broadcasting Company</a></li> <li><a href="/wiki/Johnson_Amendment" title="Johnson Amendment">Johnson Amendment</a></li> <li><a href="/wiki/Box_13_scandal" title="Box 13 scandal">Box 13 scandal</a></li> <li><a href="/wiki/Bashir_Ahmad_(camel_driver)" title="Bashir Ahmad (camel driver)">Bashir Ahmad</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Legacy and <a href="/wiki/List_of_memorials_to_Lyndon_B._Johnson" title="List of memorials to Lyndon B. Johnson">memorials</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lyndon_B._Johnson_bibliography" class="mw-redirect" title="Lyndon B. Johnson bibliography">Bibliography</a></li> <li><a href="/wiki/Lyndon_Baines_Johnson_Library_and_Museum" title="Lyndon Baines Johnson Library and Museum">Lyndon Baines Johnson Library and Museum</a></li> <li><a href="/wiki/Lyndon_B._Johnson_National_Grassland" title="Lyndon B. Johnson National Grassland">Lyndon B. Johnson National Grassland</a></li> <li><a href="/wiki/Lyndon_B._Johnson_National_Historical_Park" title="Lyndon B. Johnson National Historical Park">Lyndon B. Johnson National Historical Park</a></li> <li><a href="/wiki/Lyndon_B._Johnson_Space_Center" class="mw-redirect" title="Lyndon B. Johnson Space Center">Lyndon B. Johnson Space Center</a></li> <li><a href="/wiki/Lyndon_Baines_Johnson_Day" title="Lyndon Baines Johnson Day">Lyndon Baines Johnson Day</a></li> <li><a href="/wiki/Lyndon_B._Johnson_School_of_Public_Affairs" title="Lyndon B. Johnson School of Public Affairs">Lyndon B. Johnson School of Public Affairs</a></li> <li><a href="/wiki/Lyndon_Baines_Johnson_Memorial_Grove_on_the_Potomac" title="Lyndon Baines Johnson Memorial Grove on the Potomac">Memorial Grove on the Potomac</a></li> <li><a href="/wiki/Presidents_of_the_United_States_on_U.S._postage_stamps#Lyndon_B._Johnson" title="Presidents of the United States on U.S. postage stamps">U.S. Postage stamp</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Electoral_history_of_Lyndon_B._Johnson" title="Electoral history of Lyndon B. Johnson">Elections</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Texas%27s_10th_congressional_district" title="Texas's 10th congressional district">United States House of Representatives special elections, 1937</a></li> <li><a href="/wiki/1938_United_States_House_of_Representatives_elections" title="1938 United States House of Representatives elections">1938 United States House of Representatives elections</a></li> <li><a href="/wiki/1940_United_States_House_of_Representatives_elections" title="1940 United States House of Representatives elections">1940</a></li> <li><a href="/wiki/1942_United_States_House_of_Representatives_elections" title="1942 United States House of Representatives elections">1942</a></li> <li><a href="/wiki/1944_United_States_House_of_Representatives_elections" title="1944 United States House of Representatives elections">1944</a></li> <li><a href="/wiki/1946_United_States_House_of_Representatives_elections" title="1946 United States House of Representatives elections">1946</a></li> <li><a href="/wiki/List_of_United_States_senators_from_Texas" title="List of United States senators from Texas">United States Senate special elections, 1941</a></li> <li><a href="/wiki/1948_United_States_Senate_elections" title="1948 United States Senate elections">1948 United States Senate elections</a></li> <li><a href="/wiki/1954_United_States_Senate_elections" title="1954 United States Senate elections">1954</a></li> <li><a href="/wiki/United_States_Senate_elections,_1960_and_1961" class="mw-redirect" title="United States Senate elections, 1960 and 1961">1960</a></li> <li><a href="/wiki/1960_Democratic_Party_presidential_primaries" title="1960 Democratic Party presidential primaries">Democratic Party presidential primaries, 1960</a></li> <li><a href="/wiki/1964_Democratic_Party_presidential_primaries" title="1964 Democratic Party presidential primaries">1964</a> <ul><li><a href="/wiki/Lyndon_B._Johnson_1964_presidential_campaign" title="Lyndon B. Johnson 1964 presidential campaign">campaign</a></li></ul></li> <li><a href="/wiki/1968_Democratic_Party_presidential_primaries" title="1968 Democratic Party presidential primaries">1968</a> <ul><li><a href="/wiki/Withdrawal_of_Lyndon_B._Johnson_from_the_1968_United_States_presidential_election" title="Withdrawal of Lyndon B. Johnson from the 1968 United States presidential election">withdrawal</a></li></ul></li> <li><a href="/wiki/1956_Democratic_National_Convention" title="1956 Democratic National Convention">Democratic National Convention 1956</a></li> <li><a href="/wiki/1960_Democratic_National_Convention" title="1960 Democratic National Convention">1960</a></li> <li><a href="/wiki/1964_Democratic_National_Convention" title="1964 Democratic National Convention">1964</a></li> <li><a href="/wiki/1960_United_States_presidential_election" title="1960 United States presidential election">1960 United States presidential election</a> <ul><li><a href="/wiki/Presidential_transition_of_John_F._Kennedy" title="Presidential transition of John F. Kennedy">transition</a></li></ul></li> <li><a href="/wiki/1964_United_States_presidential_election" title="1964 United States presidential election">1964</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lyndon_B._Johnson#Personality_and_public_image" title="Lyndon B. Johnson">Public image</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lyndon_B._Johnson_in_popular_culture" title="Lyndon B. Johnson in popular culture">Lyndon B. Johnson in popular culture</a></li> <li><a href="/wiki/Daisy_(advertisement)" title="Daisy (advertisement)">Daisy advertisement</a></li> <li><a href="/wiki/Johnson_cult" title="Johnson cult">Johnson cult</a></li> <li><a href="/wiki/The_Years_of_Lyndon_Johnson" title="The Years of Lyndon Johnson">The Years of Lyndon Johnson</a></li> <li><a href="/wiki/LBJ_(1991_film)" title="LBJ (1991 film)">LBJ (1991 television film)</a></li> <li><a href="/wiki/Path_to_War" title="Path to War">Path to War (2002 film)</a></li> <li>All the Way (<a href="/wiki/All_the_Way_(play)" title="All the Way (play)">play</a>, <a href="/wiki/All_the_Way_(2016_film)" title="All the Way (2016 film)">film</a>)</li> <li><a href="/wiki/Selma_(film)" title="Selma (film)">Selma (2014 film)</a></li> <li><a href="/wiki/LBJ_(2016_film)" title="LBJ (2016 film)">LBJ (2017 film)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Family_of_Lyndon_B._Johnson" title="Family of Lyndon B. Johnson">Family</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lady_Bird_Johnson" title="Lady Bird Johnson">Claudia "Lady Bird" Taylor Johnson</a> (wife)</li> <li><a href="/wiki/Lynda_Bird_Johnson_Robb" title="Lynda Bird Johnson Robb">Lynda Bird Johnson Robb</a> (daughter)</li> <li><a href="/wiki/Luci_Baines_Johnson" title="Luci Baines Johnson">Luci Baines Johnson</a> (daughter)</li> <li><a href="/wiki/Samuel_Ealy_Johnson_Jr." title="Samuel Ealy Johnson Jr.">Samuel Ealy Johnson Jr.</a> (father)</li> <li><a href="/wiki/Sam_Houston_Johnson" title="Sam Houston Johnson">Sam Houston Johnson</a> (brother)</li> <li><a href="/wiki/Samuel_Ealy_Johnson,_Sr." class="mw-redirect" title="Samuel Ealy Johnson, Sr.">Samuel Ealy Johnson, Sr.</a> (grandfather)</li> <li><a href="/wiki/Joseph_Wilson_Baines" title="Joseph Wilson Baines">Joseph Wilson Baines</a> (grandfather)</li> <li><a href="/wiki/George_Washington_Baines" title="George Washington Baines">George Washington Baines</a> (great-grandfather)</li> <li><a href="/wiki/Chuck_Robb" title="Chuck Robb">Chuck Robb</a> (son-in-law)</li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="3"><div> <ul><li><a href="/wiki/John_F._Kennedy" title="John F. Kennedy">← John F. Kennedy</a></li> <li><a href="/wiki/Richard_Nixon" title="Richard Nixon">Richard Nixon →</a></li></ul> <ul><li><a href="/wiki/Richard_Nixon" title="Richard Nixon">← Richard Nixon</a></li> <li><a href="/wiki/Hubert_Humphrey" title="Hubert Humphrey">Hubert Humphrey →</a></li></ul> <ul><li><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /> <a href="/wiki/Category:Lyndon_B._Johnson" title="Category:Lyndon B. Johnson">Category</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q1141363#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q1141363#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <a href="https://www.wikidata.org/wiki/Q1141363#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85082855">United States</a></li><li><a rel="nofollow" class="external text" href="http://olduli.nli.org.il/F/?func=find-b&local_base=NLX10&find_code=UID&request=987007560398005171">Israel</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><a rel="nofollow" class="external text" href="https://catalog.archives.gov/id/10640639">NARA</a></li></ul></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Medicaid&oldid=1255502266">https://en.wikipedia.org/w/index.php?title=Medicaid&oldid=1255502266</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Medicare_and_Medicaid_(United_States)" title="Category:Medicare and Medicaid (United States)">Medicare and Medicaid (United States)</a></li><li><a href="/wiki/Category:Child_poverty" title="Category:Child poverty">Child poverty</a></li><li><a href="/wiki/Category:Federal_assistance_in_the_United_States" title="Category:Federal assistance in the United States">Federal assistance in the United States</a></li><li><a href="/wiki/Category:Healthcare_reform_in_the_United_States" title="Category:Healthcare reform in the United States">Healthcare reform in the United States</a></li><li><a href="/wiki/Category:Presidency_of_Lyndon_B._Johnson" title="Category:Presidency of Lyndon B. 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