State Medicaid Programs

The Medicaid program was created on July 30, 1965 through Title 19 of the U.S. Social Security Act.  Every state administers its own Medicaid program while the federal Centers for Medicare and Medicaid Services (CMS) monitors the individual state programs and establishes requirements for program service delivery, quality, funding, and individual eligibility standards.

Individual states may bundle together the administration of Medicaid with other separate programs such as the State Children's Health Insurance Program (SCHIP), so the same organization that handles the Medicaid program in a state may also manage those additional programs. Separate Medicaid programs may also exist in some localities that are funded by the states to provide health coverage for indigents and minors.  State participation in Medicaid is always voluntary.

Individual states are required to include certain types of individuals or eligibility groups under their Medicaid plans and they may include others. States eligibility groups will be considered one of the following: Categorically Needy (CN), Medically Needy (MN), or special groups.

Based on 2008 data, the Kaiser Family Foundation (KFF) reported that 43.5 million individuals were enrolled in Medicaid programs throughout the 50 states and the District of Columbia. KFF determined that was a 3% increase from the previous year.

On average, up to 20% of a states population may be eligible for Medicaid coverage. California has the largest number of people, over 10 million, enrolled in the California Medicaid program known as Medi-Cal. New York, Texas and Florida Medicaid programs combined provide coverage for about another 16 million people.

A couple of the main concerns facing the different states Medicaid programs during these difficult economic times are the increase in Medicaid enrollees and the states budget shortfalls. The American Recovery and Reinvestment Act (ARRA) did provide critical financial help to the states to reduce cuts in the Mediciad programs, but those ARRA funds will expire in the end of 2010.

In order to provide help to children in need of health coverage, the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 provides the states with the ability to enroll about 5 million eligible but uninsured low income children into the Medicaid and CHIP programs.

In order to determine the Medicaid eligiblity requirements for the state in which you live, you can do that either online or by contacting your local Social Services office. Remember, while there are federal Medicaid standards that must be met, states have the ability to provide additional Medicaid benefits. If your income is low and you are in need of health insurance coverage, you should apply for Medicaid to determine if you qualify.