10 Surprising Facts About Medicaid

Medicaid is a health insurance program covering more than 70 million people, including approximately half of all children in the U.S., as well as pregnant women, people with disabilities, senior citizens, and some adults. The program was created in 1965 to increase access to health services and to improve health outcomes for eligible populations.

Here are 10 surprising facts about Medicaid to help you understand how this vital program supports child health:  

1. Medicaid is the largest single source of health coverage for Americans

The Medicaid program is the largest single source of public health care coverage in the United States. Medicaid covers kids in every state, from every background, and provides affordable coverage to lower-income families and children with special health care needs.

2. Americans want to maintain or increase Medicaid funding

More than 80% of adults want to see funding for Medicaid maintained at current levels or increased. A KFF Health Tracking Poll administered in February found only 17% of adults want Congress to decrease federal spending on Medicaid. Most people want Congress to either increase Medicaid spending (42%) or keep it about the same (40%).

3. Many Americans are connected to Medicaid

A majority of Americans know someone who has benefitted from Medicaid. In fact, Medicaid covers 41% of all births in the United States and nearly half of children with special health care needs. According to a tracking poll by KFF, 66% of adults say they or a family member have been covered by Medicaid at some point.

4. Pediatricians and children’s hospitals see more Medicaid patients

On average, 50% of patients at children’s hospitals are Medicaid beneficiaries, and Medicaid patients make up about 35% of pediatricians’ caseloads. That’s the highest percentage among any medical specialty, according to the American Medical Association’s Physician Practice Benchmark Survey.

5. More Medicaid recipients live in rural areas

Medicaid covers a higher share of children and adults in rural areas compared to metro areas. Approximately 40% of children living in rural communities and small towns have Medicaid. In six states, at least half of children living in small towns and rural areas are covered by Medicaid. These include:

• New Mexico: 59.9%
• Louisiana: 57.7%
• Arizona: 55.9%
• Florida: 51.9%
• South Carolina: 51.1%
• Arkansas: 50.5%

6. Kids with special health care needs rely on Medicaid

Some 14 million kids – or one in five children under age 18 – have special health care needs. Nearly half are covered by Medicaid and/or the Children’s Health Insurance Program (CHIP). Of those, Medicaid is their only source of health insurance coverage, with 8% also having private health insurance.

Some children have both Medicaid and private insurance because many of the medical and long-term services Medicaid pays for are not covered or only available in limited amounts through private insurance. Access to these services keep children with complex and chronic needs living at home with their families, in their communities.

7. Military kids have Medicaid, too

According to a CHA report, 3 million infants, children, and adolescents in military-connected families are eligible for, or covered by, Medicaid. TRICARE, the health insurance program provided to military families by the Department of Defense, may fall short of meeting all of children’s physical and mental health needs, particularly for a child with a complex medical condition. Medicaid covers these gaps.

8. Medicaid programs have a variety of names

States call their Medicaid programs by very different names. In many states, the program is referred to as the state name, followed by the word Medicaid. For instance, Maryland Medicaid or Michigan Medicaid.

Twenty-seven states use names that don’t directly tie the service to the Medicaid program.

Examples:

• Alaska: Denali Care
• Arizona: Arizona Health Care Cost Containment System (AHCCCS)
• Connecticut: Husky Health
• Missouri: MO HealthNet
• South Carolina: Healthy Connections
• Wisconsin: BadgerCare

9. Medicaid is a joint federal-state program

Medicaid is jointly funded by both the federal government and state governments. States administer the program under broad federal rules. The federal government contributes at least 50% but no more than 83% of funding for each state’s Medicaid program. The amount is based on each state’s Federal Medical Assistance Percentage (FMAP), a measure of state wealth relative to the national average.

10. States fund their share of Medicaid in a variety of ways

States fund their share of the program from a variety of sources, including general revenue and health-care related taxes, assessments, or fees. Often called “provider taxes,” each state determines which providers to tax (e.g. hospitals and health systems, nursing facilities, managed care organizations) and how to apply the tax.

Provider taxes are legal mechanisms allowed by Congress and can be applied as a flat tax, a fee per admission or bed, a share of net revenue, or in other ways. Without these taxes, states would not be able to sustain the Medicaid program for children and adults.

Learn more about how Medicaid impacts kids’ lives and how Children’s Hospital Association is working to protect and strengthen this lifesaving program.