Medicaid 101: What You Need to Know

March 20, 2015

With some states grappling over whether to expand Medicaid, and Congress facing big decisions about the future of the Children’s Health Insurance Program (CHIP), this briefing reviewed the basics about both programs and discuss current issues.

Medicaid is a federal-state partnership that provides health coverage to low-income individuals, including families, people with disabilities, and seniors. Since the enactment of the Affordable Care Act (ACA), more adults can now qualify for Medicaid coverage in states that have expanded the program. According to the Centers for Medicare and Medicaid Services (CMS), approximately 69 million adults and children were enrolled in Medicaid and CHIP as of November 2014.

What is Medicaid, and why was it created? What benefits does the program cover? What do we know about enrollment and expenditures in Medicaid? How is the program financed and administered? What changes did the ACA make to Medicaid? What are the trends in delivery system and payment reform across states, and what are their policy implications? What are the key issues facing Medicaid? With CHIP funding set to expire on September 30, 2015, what does the future hold for children’s health coverage?

If you were unable to attend the briefing, here are some key takeaways:
Robin Rudowitz, associate director, Kaiser Commission on Medicaid and the Uninsured
Robin Rudowitz stated that Medicaid covers 1 in 5 Americans. She also noted that spending for the elderly and disabled patients accounts for two-thirds of Medicaid spending. Twenty-nine states including DC have adopted the Medicaid expansion, she added.

Thomas Betlach, president of the board, National Association of Medicaid Directors, and director
According to a NAMD survey, 77% of Medicaid directors identified their top four priorities as: payment and delivery reform, implementation of the Affordable Care Act, Long-Term Services and Supports and duals, and eligibility and enrollment systems. Turnover among Medicaid directors and maintaining staff poses a challenge for moving the program forward, he stated.

Anne Schwartz, executive director, Medicaid and CHIP Payment and Access Commission (MACPAC)
Anne Schwartz highlighted that the number of uninsured children has dropped by half since the enactment of the Children’s Health Insurance Program (CHIP). While reauthorization for the program is not needed, extended CHIP funding for the program is set to expire on September 30, 2015. She added that 3.7 million children would need a new source of coverage if CHIP funding is not renewed.

Vikki Wachino, acting director, Center for Medicaid and CHIP Services, CMS
Since open enrollment period began in October 2013, 11 million people have enrolled in Medicaid and CHIP, serving as a testament to CMS’s success in making the enrollment process simpler and more consumer friendly, Vikki Wachino said. But, benefits extend past just enrollment numbers. In Kentucky, for example, 15,000 jobs have been created as a result of Medicaid expansion, she added.

Ed Howard of the Alliance and Barbara Lyons of Kaiser moderated.

Follow the briefing on Twitter: #Medicaid101

Contact: Beeta Rasouli (202)789-2300

The event was sponsored by the nonpartisan Alliance for Health Reform and The Henry Kaiser Family Foundation.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Robin Rudowitz Presentation (Adobe Acrobat PDF)
Thomas Betlach Presentation (Adobe Acrobat PDF)
Anne Schwartz Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)

Event Resources