Medicaid Program | Commonwealth Fund

Medicaid is a crucial a part of the U.S. social security internet. The joint federal–state program allows hundreds of thousands of individuals with low earnings, together with youngsters, pregnant ladies, and folks with disabilities, to entry the well being care they want. Right this moment, Medicaid’s attain is bigger than ever: this system is now the nation’s largest insurer, protecting round 80 million Individuals. Medicaid pays for greater than two in 5 births, and a fair higher share for folks of shade and folks in rural areas. It’s additionally the nation’s main payer for behavioral well being and long-term care providers.

Many years of proof reveals that Medicaid facilitates entry to care, improves well being, and protects the monetary well-being of the folks it serves. Nonetheless, this system and its beneficiaries face a number of challenges. Individuals eligible for Medicaid usually battle to enroll or maintain their protection for prolonged durations due to this system’s advanced eligibility standards and utility processes. Beneficiaries additionally could have hassle discovering suppliers that settle for Medicaid — significantly specialty care suppliers — as a result of its cost charges are typically decrease than charges paid by different insurers. Addressing these challenges, whereas curbing rising program prices, is a key concern for states, which oversee their Medicaid packages and, along with the federal authorities, fund them.

The Commonwealth Fund goals to tell policymakers’ efforts to boost protection, enhance entry to care, and advance well being fairness within the Medicaid program. We achieve this by investing in tasks that:

• Monitor states’ growth of Medicaid eligibility and study the impression on protection, state economies, and budgets.
• Monitor federal and state modifications to Medicaid coverage and consider their results on entry to care, well being outcomes, and well being fairness.
• Present technical help and state-to-state studying alternatives for Medicaid leaders.

Program Contact:

Akeiisa ColemanSenior Program Officer, Medicaid

2025 Program Funding Priorities

• Guaranteeing Medicaid is assembly the wants of all enrollees.
• Enhancing the continuum of behavioral well being providers that Medicaid covers, particularly for kids and adolescents.
• Guaranteeing the sustainability of Medicaid long-term providers and helps whereas enhancing entry to and high quality of home- and community-based providers.