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In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
The Medicaid coverage gap includes nonelderly people with incomes that are below the federal poverty line (FPL), making them ineligible for subsidized marketplace insurance under the Affordable Care Act (ACA), but have incomes higher than their state's limit for Medicaid eligibility as their state has not adopted Medicaid expansion as ...
This is exacerbated by the 2012 Supreme Court decision allowing states to opt out of Medicaid, since many of the states that have opted out have more vulnerable populations, with large numbers of minorities or low-income people. [247] Medicaid patients have also reported receiving "second-class" treatment compared to privately insured patients ...
Congress passed the original Medicaid program in 1965 as a health insurance safety net for the most vulnerable low-income people in the United States. These individuals include the poor, parents ...
Medicaid is funded by the federal and state governments, which both played a role in unwinding — with states executing the redeterminations and the federal government providing oversight.
People who are dropped from Medicaid can regain coverage retroactively if they submit information within 90 days proving their eligibility. But some advocacy groups say that still poses a challenge.
The resulting payment structure reimbursed health centers on the basis of their actual costs for providing care, not by a rate negotiated with the state Medicaid agency or set by Medicare. Medicaid's shift to a managed care delivery system in the 1990s required CHCs to again modify their financial structure.
The widely held assumption for decades was that Medicaid, which only benefits poor people, was more politically vulnerable than Medicare, which is virtually sacrosanct because it benefits everyone.