{"id":1530,"date":"2023-03-03T01:14:08","date_gmt":"2023-03-03T01:14:08","guid":{"rendered":"https:\/\/law-oh.com\/?p=1530"},"modified":"2023-02-17T17:56:58","modified_gmt":"2023-02-17T17:56:58","slug":"a-basic-understanding-of-medicaid","status":"publish","type":"post","link":"https:\/\/law-oh.com\/a-basic-understanding-of-medicaid\/","title":{"rendered":"A Basic Understanding of Medicaid"},"content":{"rendered":"

The Medicaid program provides comprehensive health coverage and financial protection to millions of Americans. The program helps low-income families, individuals, and people with disabilities receive adequate health care and provides nursing home or community long-term care services. As of August 2022, more than\u00a090.5 million<\/a>\u00a0individuals were part of the Medicaid and Children\u2019s Health Insurance Programs (CHIP<\/a>).<\/p>\n

States Follow Federal Guidelines But Have Some Autonomy<\/h1>\n

Although Medicaid funding is a federal-state partnership, states administer the programs and have some flexibility in determining who to cover, delivery models, and payment methods for physicians and hospitals. States may apply for a Section 1115 waiver<\/a> to experiment with different implementation approaches as federal statutes require; however, the Secretary of the US Department of Health & Human Services (HHS<\/a>) determines advanced program objectives.<\/p>\n

Medicaid entitlement has two basic guarantees. First, all Americans who meet Medicaid eligibility requirements are guaranteed healthcare coverage. Second, states receive guarantees for federally matched funds without a cap for enrollees\u2019 qualified services. Under current law, nearly all Medicaid federal funding is open-ended, but this may change for cost containment.<\/p>\n

According to the Congressional Budget Office<\/a> (CBO<\/a>), the federal government pays anywhere from 54 percent to 79 percent of each state\u2019s annual Medicaid outlays, with the states\u2019 picking up the remainder. Beyond enrollment expansion due to COVID-19 for the fiscal year 2022<\/a>, nearly one-third of states saw upward pressure on spending due to increasing costs for managed care and provider rate increases.<\/p>\n

Medicaid Coverage Continues to Evolve<\/h1>\n

Medicaid began in 1965 and was a cash assistance program for qualifying individuals or families. In the following years, Congress expanded federal minimum requirements to provide more new coverage types, particularly for children, pregnant women, and people with disabilities. The broader health care coverage of the Affordable Care Act (ACA<\/a>) in 2010 expanded Medicaid to non-elderly adults with qualifying low incomes and continues to meet changing needs.<\/p>\n

A Broad Range of Health and Long-Term Care Services<\/h1>\n

In addition to the Medicaid federal law service requirements, many states provide optional services. These services include physical therapy, prescription drugs, eyeglasses, and dental care. Medicaid expansion for adults is part of the ACA\u2019s ten \u201cessential health benefits<\/a>,\u201d which include the following:<\/p>\n