Medicaid is a government health insurance program for low-income families and individuals established in 1965 under President Lyndon B. Johnson as part of the Social Security Amendments. It is administered by individual states according to federal guidelines and provides coverage for various medical services and benefits. While states pay 50% of costs, there is ongoing controversy around eligibility requirements and costs as states aim to reduce spending through managed care programs while maintaining federal funding.

1. Medicaid
Kyla Hull, Sam Igel, Annalise Jouett, and
Andrew Kollmann

2. Medicaid - Basic Overview
● Gov’t insurance program for low income
families
● Created in the Social Amendments of 1965
● Under Lyndon B Johnson

3. Qualifications
● US Citizen or Legal Resident
● Income below poverty level

4. Categories
● Different states have different categories;
some include:
● Blindness
● Disability
● Pregnancy
● Assets
● Resources
● Age
● Citizenship

5. Federal Benefits
● Inpatient, Outpatient Hospital Services
● Home Health Services
● Physician Services
● Rural Health Clinic Services
● Laboratory Services
● X-Ray Services
● Family Planning Services
● Pre-Natal Care
● Tobacco Cessation Services

6. State Benefits
● Pharmacy Benefits
● Clinic Services
● Physical Therapy
● Occupational Therapy
● Respiratory Care
● Mental Health Services
● Dental Services
● Optometry Services

7. Controversy
● The states and the federal gov’t could not
agree on the amount of money each should
pay for the program when it was first
suggested.

8. Controversy Today
● It has been in the news recently because of
the eligibility requirement changes made in
2013.
● It is now controversial because the Obama
Administration has offered to pay for any
new people that the states can put on
Medicaid.

9. Modifications
● The Patient Protection and Affordable Care
Act, passed in 2010, will expand Medicaid
eligibility starting in 2014.

10. Overseer
● The US Department of Health and Human
Services oversees Medicaid.
● It is up to the states to administer the
program.

11. Program Cost
● The program’s cost varies from state to
state.
● The State pays 50% of the cost and the
federal gov’t pays for the other 50%.

12. State Participation
● State participation is voluntary
● All states have participated since 1982

13. State Administration
● States may bundle the administration of
Medicaid with other programs, therefore the
the same organization that handles Medicaid
within a state may also manage additional
programs.

14. Managed Care
● Managed care allows states to reduce costs
without reducing benefits.
● Changing the system allows states to cut
high payments to pharmacies.
● States worry that they would lose federal
rebates for medications and would be unable
to negotiate with pharmacies for lower prices
if they moved to managed care.

15. Multiple Choice #1
States are happy because…
A. cost for medicine is getting lower.
B. cost for medicine is getting higher.
C. States are not happy because the
price of medicine is getting higher.
D. several states have reduced
Medicaid spending.

16. Answer
The correct answer is C

17. Multiple Choice # 2
What does managed care do?
A. Provide money for health care.
B. Offer possible guidelines for health
care.
C. Demand guidelines for health
care.
D. Force all states to conform to
certain guidelines.

18. Answer
The correct answer is B.

19. Multiple Choice #3
What do states worry about when it
comes to managed care?
A. They would lose federal rebates for
medications.
B. States would reduce costs therefore
reduce benefits.
C. Higher payments to pharmacies would be
required.
D. States would have to negotiate with
pharmacies to get lower prices.

20. Answer
The correct answer is A.

21. Multiple Choice #4
What year was Medicaid established?
A. 1970
B. 1997
C. 1963
D. 1965

22. Answer
The correct answer is D.

23. Multiple Choice #5
Who was president when Medicaid was
established?
A. Richard Nixon
B. John F. Kennedy
C. Lyndon B. Johnson
D. Gerald Ford

24. Answer
The correct answer is C.

25. Sources
● www.ncpa.org/pub/5a566
● www.medicaid-help.org
● www.en.wikipedia.org/wiki/Medicaid