Medicaid was signed into law in 1965 with the passing of Title XIX by then President Lyndon B. Johnson as part of the Social Security Act. Subsequently CHIP(Children’s Health Insurance Program) was created in 1997 to provide health insurance and preventive care for uninsured children. The program is jointly run by the state and federal government.
Medicaid provides medical assistance to eligible individuals and families with low incomes or other factors such as disabilities. Each state has it’s own eligibility standards. A person may be eligible for Medicaid in one state and not eligible in another. Each state also sets its own coverage of services and payment rates. A few services covered by Medicaid include: inpatient/outpatient hospital services, labs and x-rays, nursing facilities and physician services.
States are able to contract directly with providers or through an HMO(health maintenance organization) in order to arrange payment of eligible services. If you are in Vermont, this is Green Mountain Care.
There are some constituents that are known as dual members who are eligible for both Medicare and Medicaid. This dual coverage is crucial for services such as nursing facility care beyond 100 days, hearing aids and prescription drugs to name a few.
As of October 2024, over 79 million people were enrolled in Medicaid and CHIP. Of that number roughly 157,000 people are in Vermont. As of CY2022, the average per capita cost for Medicaid is $9,108. This number is per enrollee by state for all eligibility groups.
The latest budget that was approved states “(4) COMMITTEE ON ENERGY AND COMMERCE.—The Committee on Energy and Commerce shall submit changes in laws within its jurisdiction to reduce the deficit by not less than $880,000,000,000 for the period of fiscal years 2025 through 2034“. The Energy and Commerce Committee oversees: The Department of Health and Human Services(which Medicare and Medicaid fall under), Department of Energy, Environmental Protection Agency, Federal Trade Commission, Food and Drug Administration and the Federal Communications Commission.
I share this primer on Medicaid as well as the text from the budget cuts to provide people with the information to come to their own conclusions about what these cuts might mean for not only for themselves but their families and community.
Resources utilized in this article:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4194683/
https://www.chcs.org/media/Medicaid-Timeline-Fact-Sheet_01.14.20v2.pdf
https://docs.house.gov/meetings/BU/BU00/20250213/117894/BILLS-119NAih.pdf
