Federal Medicaid policy
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Health Policy Tracking Service issue brief
- Author(s):
- Raduege, Tammy J., author
- Contributor(s):
- Thomson Reuters, issuing body.
- Publication:
- [Toronto, Ontario] : Thomson Reuters, 19-December-2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Federal Government Health Policy -- legislation & jurisprudence Medicaid -- organization & administration Community Health Services COVID-19 Maternal Health Services Mental Health Services Social Determinants of Health United States
- Genre(s):
- Technical Report
- Abstract:
- Created as Title XIX of the Social Security Amendments of 1965, Medicaid is a medical assistance program administered by the states and funded through federal and state revenues. While the program has evolved over the years, many of the basic objectives and provisions have remained mostly intact. The federal government sets out and monitors certain requirements, including funding, limits on cost-sharing, and the scope of medical services. When developing their Medicaid programs, states are allowed to make some of their own decisions in the areas of eligibility, reimbursement rates, benefits, and delivery of services, as long as they stay within the federal guidelines. A state must seek a waiver from the federal government to create a program outside the federal guidelines if it wishes to use federal funds. Because it is a joint program, the federal government and states share Medicaid funding, with the federal government contributing at least 50 percent to each state for administrative costs. For medical services provided under the program, the federal medical assistance percentage (FMAP), or matching rate, varies among states. The FMAP is based on per capita income and ranges from a low of 50% to a high of about 75% percent across the states. In one of his first acts after being inaugurated, President Joseph Biden (D) issued an executive order to strengthen Medicaid and reopen the Affordable Care Act Marketplace open enrollment. Section 1 of the order cites the positive effect the Affordable Care Act has had on reducing the uninsured rate in the country, establishing consumer protections, and strengthening the health care system. He notes, however, that many eligible people still remain uninsured, and he said that his administration views health care as a priority: ‘[I]t is the policy of my Administration to protect and strengthen Medicaid and the ACA and to make high-quality healthcare accessible and affordable for every American,” he wrote. Section 3 of the order directs all agency heads to review their regulations, policies, guidance documents, and other papers to ensure that they advance the priorities stated in Section 1: (a) The Secretary of the Treasury, the Secretary of Labor, the Secretary of Health and Human Services, and the heads of all other executive departments and agencies with authorities and responsibilities related to Medicaid and the ACA (collectively, heads of agencies) shall, as soon as practicable, review all existing regulations, orders, guidance documents, policies, and any other similar agency actions (collectively, agency actions) to determine whether such agency actions are inconsistent with the policy set forth in section 1 of this order. As part of this review, the heads of agencies shall examine the following: . . . . (ii) demonstrations and waivers, as well as demonstration and waiver policies, that may reduce coverage under or otherwise undermine Medicaid or the ACA; . . . . (iv) policies or practices that may present unnecessary barriers to individuals and families attempting to access Medicaid or ACA coverage, including for mid-year enrollment; and (v) policies or practices that may reduce the affordability of coverage or financial assistance for coverage, including for dependents. President Biden remarked that he is '“restoring the Affordable Care Act and restoring the Medicaid [program] to the way it was before Trump became president, which by fiat he changed, made more inaccessible, more expensive and more difficult for people to qualify for either of those two items.'‘
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (67 pages)).
- NLM Unique ID:
- 9918662285706676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918662285706676