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“Medicaid was enacted in 1965 as part of the same law that created the Medicare program (the Social Security Amendments of 1965; P.L. 89-97). Medicaid was designed to provide coverage to groups with a wide range of health care needs that historically were excluded from the private health insurance market (e.g., individuals with disabilities who require LTSS or indigent populations in geographic locations where access to providers is limited). Because of the diversity of the populations that Medicaid serves, Medicaid offers some benefits that typically are not covered by major insurance plans offered in the private market (e.g., institutional and home and community-based LTSS or early and periodic screening, diagnostic, and treatment [EPSDT] services).²“

Source: Alison Mitchell, et al. Medicaid: An Overview. CRS R43357. Congressional Research Service: Washington, DC. Updated Feb 8, 2023, last accessed July 7, 2023.

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“Historically, Medicaid eligibility was limited to poor families with dependent children who received cash assistance under the former Aid to Families with Dependent Children (AFDC) program, as well as poor aged, blind, or disabled individuals who received cash assistance under the Supplemental Security Income (SSI) program. Medicaid eligibility rules reflected these historical program linkages both in terms of the categories of individuals who were served and in that the financial eligibility rules were generally based on the most closely related social program for the group involved (e.g., AFDC program rules for low-income families with dependent children and pregnant women, and SSI program rules for aged, blind, or disabled).¹⁹ Over time, Medicaid eligibility has expanded to allow states to extend Medicaid coverage to individuals beyond those who were eligible based on receipt of cash assistance. Eligibility expansions include new groups of individuals who are less likely to have access to and/or are able to afford health insurance coverage, such as foster care youth through the age of 26 without regard to annual income, and the ACA Medicaid expansion population (i.e., nonelderly adults with income up to 133% of FPL).²⁰ Medicaid’s financial eligibility rules also have been modified over time for certain groups.²¹“

Source: Alison Mitchell, et al. Medicaid: An Overview. CRS R43357. Congressional Research Service: Washington, DC. Updated Feb 8, 2023, last accessed July 7, 2023.

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“Historically, in a typical year, the average federal share of Medicaid expenditures was about 57%, which means the average state share was about 43%. However, the federal government’s share of Medicaid expenditures increased since the implementation of the ACA Medicaid expansion in January 2014, because the federal government is funding a vast majority of the cost of the expansion through the enhanced federal matching rates.⁷² In addition, the FFCRA 6.2-percentage-point increase to the FMAP rates during the COVID-19 public health emergency has increased the federal share of Medicaid since January 2020. In FY2021, the average federal share of Medicaid is estimated to have been 69%.⁷³“

Source: Alison Mitchell, et al. Medicaid: An Overview. CRS R43357. Congressional Research Service: Washington, DC. Updated Feb 8, 2023, last accessed July 7, 2023.

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World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated March 17, 2025 by Doug McVay, Editor.