Issues facing America: Medicaid

By Samir Mehta MD; Ryan Nunley, MD, and the Washington Health Policy Fellows

Perhaps no governmental healthcare programs have helped as many people as Medicare and Medicaid. The Medicaid program is the third largest source of health insurance in the United States—after employer-based coverage and Medicare. But, just as the Medicare program is facing overload, with millions of “baby boomers” soon to qualify, the Medicaid program—a joint venture between federal and state governments—is also under stress. Indeed, many of the problems faced by patients and physicians in the Medicare program are exacerbated in the Medicaid population.

How we got here
Medicaid and Medicare both result from Title XIX of the Social Security Act passed by Congress in 1965. Medicaid was established as an entitlement program that provided federal matching grants to states for the purpose of financing medical care for certain underprivileged groups. Initially, Medicaid was aimed at indigent care. Although some federally mandated provisions for healthcare services were built into the Medicaid program, each state also had the option to broaden coverage.

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