“Medicaid is a joint federal-state program that finances the delivery of primary and acute medical services, as well as long-term services and supports (LTSS), to a diverse low-income population, including children, pregnant women, adults, individuals with disabilities, and people aged 65 and older.
“State participation in Medicaid is voluntary, although all states, the District of Columbia, and the territories<sup>1</sup> choose to participate. States must follow broad federal rules to receive federal matching funds, but they have flexibility to design their own versions of Medicaid within the federal statute’s basic framework. This flexibility results in variability across state Medicaid programs.
The federal government and the states jointly finance the Medicaid program. Federal Medicaid spending is an entitlement, with total expenditures dependent on state policy decisions and use of services by enrollees. Medicaid is an entitlement for both states and individuals. The Medicaid entitlement to states ensures that, so long as states operate their programs within the federal requirements, states are entitled to federal Medicaid matching funds. Medicaid also is an individual entitlement, which means that anyone eligible and enrolled in Medicaid under his or her state’s eligibility standards is guaranteed Medicaid coverage.
In FY2018, Medicaid is estimated to have provided health care services to almost 75 million individuals at a total cost of $616 billion, with the federal government paying $386 billion of that total.<sup>2</sup> In comparison, the Medicare program provided health care benefits to nearly 59 million individuals in that same year at a cost of roughly $711 billion.<sup>3</sup>
Medicaid provides a health care safety net for low-income populations,4 with approximately 21% of the U.S. population with Medicaid coverage in 2017.5 Medicaid plays a more significant role for certain subpopulations. For example, in 2017, Medicaid provided health coverage for 39% of all children in the United States;6 in the same year, it provided health coverage for 61% of all nonelderly individuals with income below 100% of the federal poverty level (FPL).<sup>7</sup>”
Source: U.S. Congressional Research Service. Medicaid: An Overview (R43357; June 24, 2019). https://crsreports.congress.gov/product/pdf/R/R43357