Medicaid has long been a crucial program providing health coverage to low-income and vulnerable populations including children, pregnant women, the disabled, and elderly.
While Medicaid eligibility and benefits are determined at the state level, the program has evolved over time through policy changes and waivers to expand access and better meet families’ needs.
Shifting Medicaid Eligibility and Coverage
When Medicaid was established in 1965, it mainly covered certain categories of low-income individuals, including children, pregnant women, the disabled, and elderly.
The Affordable Care Act significantly expanded Medicaid eligibility to nearly all low-income individuals. States that adopted the Medicaid expansion now cover adults with incomes up to 138% of poverty.
Medicaid benefits have also expanded over time. All states cover mandatory benefits like hospital stays, doctor visits, and emergency care. Many states also provide additional benefits such as prescription drugs, mental health services, and home health care.
Some states are using Medicaid waivers to provide non-traditional benefits targeting social determinants of health.
New Opportunities to Improve Health Outcomes
Section 1115 waivers have given states more flexibility to customize their Medicaid programs. States are testing innovative approaches to improving health outcomes and reducing costs through waivers.
For example, some states are providing housing and nutrition benefits for certain Medicaid enrollees. Other states have waivers to expand Medicaid coverage for children in foster care until age 26 and provide community-based long term care options for seniors and disabled individuals.
The Biden administration aims to promote continuity of coverage during and after the pandemic. States now have options to extend Medicaid coverage for 12 months postpartum and provide 12 months of continuous coverage for children.
These changes help ensure that families do not face gaps in coverage due to temporary changes in income or life circumstances.
Medicaid Support for Families in Need
For families seeking Medicaid coverage, the best approach is to explore options on Healthcare.gov and with your state's Medicaid office. Medicaid programs vary significantly between states, so understanding your state's eligibility rules and application process is key.
Many community organizations also provide personalized help applying for Medicaid and connecting with other resources.
Medicaid has evolved to become a vital source of health coverage and financial security for millions of families. Waivers and policy changes have created more opportunities for states to meet their residents' needs.
With the help of community organizations, families can access this crucial public benefit during times of medical need or financial hardship. Medicaid provides stability and peace of mind for families facing uncertain circumstances.
