Health care is one of the most hotly debated topics in the United States. One argument concerns whether the government should provide universal health care coverage, or whether individuals should purchase their own private policies. As of 2010, the federal government funds two health insurance initiatives for many American citizens--Medicare and Medicaid. Medicaid, a joint federal-state program, covers the cost of medical care for part of the population.
Features
Each state administers its own Medicaid program with the federal government contributing a portion of the cost. States must follow guidelines established by the federal government in order to receive this money. While states maintain the freedom to define eligibility guidelines and the services covered under the program, they must provide Medicaid to certain groups mandated by the federal government. Most states provide basic medical care, such as prenatal care, basic hospital services, X-rays, children's vaccines, home health care and nursing home care.
Origin
During the 1960s, Americans acknowledged the impact of poverty on society. The Social Security Act of 1965 contained amendments establishing health care insurance for the elderly, Medicare, and for the poor under age 65, Medicaid. The Medicaid Amendments provided health care services for low-income children and their care-taker relatives, the blind, disabled individuals and the elderly. The federal government made money for Medicaid available to the states on Jan. 1, 1966. States implemented their programs over a period of several years.
Expansion of Coverage
Legislation during the 1980s and 1990s broadened the scope of Medicaid coverage to include other aspects of health care. The federal government expanded coverage to include pregnant women, along with infants up to 1 year old in 1986. The Omnibus Reconciliation Act of 1990 established the Medicaid Drug Rebate Program, which authorizes state Medicaid programs to reimburse pharmaceutical companies for providing drugs at discounted prices. This law requires drug manufacturers to sign a rebate agreement with the Centers for Medicare and Medicaid Services--the section of the U.S. Department of Health and Human Services that oversees state Medicaid programs--for their products to be eligible for Medicaid coverage.
Reduction of Spending
Medicaid spending came under increasing scrutiny during the 2000s. President George W. Bush signed the Deficit Reduction Act of 2005, which was designed to reduce federal Medicaid expenditures between 2006 and 2015, into law on Feb. 8, 2006. This act allows states to charge premiums or co-payments for some services to certain beneficiaries. It also increases the amount of time new Medicaid nursing home beneficiaries would have to wait to begin receiving benefits after transferring their assets. In addition, the 2005 Deficit Reduction Act requires most new applicants to provide documents, such as a valid U.S. passport, driver's license or birth certificate, proving their citizenship.
On-going Issues
Issues, such as an emphasis on health care reform, rising medical care costs and the aging of Baby Boomers will continue to affect the Medicaid program. In 2009, the public pressured Congress to enact legislation to reform the health care system and to ensure adequate health care insurance for the population. The resulting legislation, the Health Care and Education Reconciliation Act of 2010, increases Medicaid coverage. It requires states to expand their Medicaid programs to include more non-elderly, low-income individuals, such as adults without dependent children.
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