Our Health Policy Matters

As Congress works through the challenge of changing Obamacare, how the federal government pays its share of Medicaid dollars will be part of the debate. At first, Medicaid was designed primarily to offer to people with chronic conditions the long-term care benefits that Medicare did not. It pays much of our nation’s nursing home bill.  It was later expanded to provide safety net insurance to low income families, especially for women and children. Medicaid is a federal/state partnership program. The states design their own programs within federally-established rules, and the federal government reimburses half (or more) of the state’s cost. The Affordable Care Act added a new wrinkle to the cost-sharing formula.  For those states that expanded the Medicaid program to serve even more people, including uninsured single adults, it offered 90+ percent reimbursement for the new populations.  To date, 32 states have expanded. What’s wrong with Medicaid? Medicaid costs the federal g