Medicaid has been around since 1965 and insures 20 percent of Americans. It’s the second-biggest source of health coverage for Americans, after employer insurance. The American Health Care Act that has passed the House of Representatives (but not the Senate) would for the first time ever cap spending on this program.
“That would end Medicaid as we know it,” says Judith Solomon, a Medicaid expert at the Center on Budget and Policy Priorities, a Washington think tank.
A safety net for long-term care and more
Until the Affordable Care Act came along, Medicaid was available almost exclusively to several broad categories of low-income Americans: the elderly, the disabled, children, pregnant women, and near-destitute parents of young children.
And it still covers about half of all births. At the other end of people’s lifespan Medicaid pays 53 percent of the total national bill for long-term care, including community services that help frail elderly Americans stay in their homes.
It is, in effect, the safety-net insurer for nursing home care, given that Medicare’s nursing home benefits are extremely limited.
Starting in 2014 the ACA expanded Medicaid, and about 11 million low-income adults in 31 states who were previously ineligible for any form of Medicaid qualified for coverage.
Another 3 million people were eligible all along but didn’t realize it until they applied for coverage under the ACA. But 19 states, mostly in the South and West, decided not to expand Medicaid.