Medicaid
Medicaid (Medical Assistance) is a health care program for low-income groups , children, the elderly, and people with disabilities in the United States that is organized by the individual states and funded equally with the federal government . A means test is required to receive Medicaid benefits .
history
Medicaid was created in 1965 through the Great Society's Social Security Act of 1965 , a supplement to the United States' social security system introduced in 1935 . Each state has its own Medicaid program that the Centers for Medicare and Medicaid Services (CMS) centrally monitor. The individual states organize their Medicaid programs very differently. In some cases, private insurance companies are commissioned with the processing, sometimes the state also contracts service providers such as doctors directly. The program may have a different name in each state, examples being “ Medi-Cal ” in California , “ MassHealth ” in Massachusetts, and “ TennCare ” in Tennessee .
In 1985, 19.2 million citizens, or 8.1 percent of the US population, had Medicaid coverage; in 1994 it was 33.5 million, and according to CMS, over 46 million citizens received Medicaid benefits in 2001, 2006 finally 57.8 million citizens, including 30.2 million children.
Financing and billing
Medicaid is financed by federal, state and local taxes, with mixed financing being regulated in such a way that the federal government bears 50 to 80 percent of the costs, depending on the per capita income of the individual states rich states there. Medicaid is one of the largest budget items in most state budgets, with an average of a quarter of the spending going into this program. In 1994, 33.5 million citizens used Medicaid at a cost to the federal government of $ 77.4 billion and the cost of the state to $ 58.2 billion.
The remuneration of medical services determine the Centers for Medicare and Medicaid Services based on suggestions of in the American Medical Association settled Specialty Society Relative Value Scale Update Committee (RUC).
Medicare
Even if their names sound similar, Medicaid and Medicare are based on different concepts: While the latter is more aimed at people aged 65 and over within the health system in the United States and has contributions, deductibles and advance payments like classic health insurance , Medicaid is a social assistance-like benefit. which presupposes a significant impoverishment of the recipient as a criterion for the neediness, but if necessary both criteria can also be fulfilled. For example, approximately 6.5 million Americans are on both programs at the same time; that is, they meet the eligibility criteria for both Medicaid and Medicare .
care insurance
In the USA there is essentially no possibility of insuring yourself against the financial burdens of long-term care. In most cases, those affected finance their care costs, at least initially, from their own resources, as Medicaid can only be used after their own assets have been completely consumed ( subsidiarity ).
Individual evidence
- ↑ http://www.socialsecurity.gov/policy/docs/statcomps/supplement/2009/medicaid.pdf
- ^ Haley Sweetland Edwards: Special Deal , Washington Magazine, July / August 2013
Web links
- Read Congressional Research Service (CRS) Reports regarding Medicaid
- Substantial resources on Medicaid including federal eligibility requirements, benefits, financing and administration from Kaiser Family Foundation .
- State Health Facts: Data on health care spending, utilization, and insurance coverage, including details extensive Medicaid information from Kaiser Family Foundation .
- State of the States 2006 - Information on state health reforms, including Medicaid (PDF).
- Medicaid information from Families USA
- Medicaid Reform - The Basics from The Century Foundation
- National Association of State Medicaid Directors Organization representing the chief executives of state Medicaid programs.
- Ohio Medicaid Basics A primer on one state's Medicaid program.