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State Representative Gary Elkins (R-TX) has been maligned for asking "What's Medicaid?" three hours into a hearing but at least he wasn't afraid to ask. Given that Medicaid is perhaps the least discussed and least understood of government health programs, it's time to give it the attention it deserves.
Medicaid is a cornerstone of the nation's health care infrastructure, accounting for about one in every six health care dollars spent in the U.S. This year, it will cover nearly 68 million children, parents, pregnant women, seniors, and people with disabilities. It covers almost two-thirds of all poor children, more than four out of ten births, and helps pay nursing home costs for almost two-thirds of all nursing home residents. Medicaid relieves other insurers and payers of the responsibility of covering a population whose health care needs can be complex and costly and who have little or no ability to purchase care that is not covered. In other words, Medicaid covers many of those that the private insurers don't want.
As we enter the health reform debate, it is crucial that policymakers understand the significance of Medicaid. Most reform plans, including those advanced by then Candidate Obama, Senator Baucus, and the Association of Health Insurance Plans, contemplate that Medicaid will be maintained and expanded in a reformed health care system. If the goals of health reform are to be met, Medicaid will not only need to be maintained, it must be strengthened and fully integrated with other core components of the health care system. Georgetown University Center for Children and Families recently issued a report highlighting the need for improvements in coverage, access, quality and efficiency in Medicaid. It's time to give Medicaid the attention and support it deserves.
I recall reading somewhere that Mediciad covers people with greater health needs for less money than private insurers. Have you seen any studies that compare the two?
There are studies that show just that -- the most recent one is by Leighton Ku and Matt Broaddus and appeared in the online issue of the journal Health Affairs in June 2008.
It's worth noting that the states have a huge role in Medicaid, essentially administering the program, unlike Medicare, which is entirely federal. Ask most Republican governors and they will tell you they wouldn't want to give up their Medicaid programs.