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Enacted in 1965, Medicaid has become the backbone of USA's health care safety net, providing health coverage for nearly 59 million low-income Americans, including families, people with disabilities, and the elderly. Nowadays, Medicaid provides for almost 30 million children in the United States and pays for approximately half of all long-term care costs. Those receiving Medicaid are among the least healthy of the American people. About 68 percent of Medicaid spending covers services for disabled, blind, and nursing-home-confined elderly. Those beneficiaries require extremely costly health care. Medicaid is a program jointly funded by the states and the federal government. Medicaid provides health coverage for children and adults of low income, medical and long-term care coverage for people with disabilities, and assistance with health and long-term care expenses for low-income seniors. The mandatory benefits of Medicaid include physician services, hospital services, family planning, health center services, and nursing facility services.
The package from Medicaid to benefit children is more comprehensive than the one for adults because federal law requires states to provide coverage for certain health screenings and services that are medically necessary. States are normally allowed to provide coverage for certain other health care services that are approved by the federal government. The optional services include the benefits such as dental care, fittings for optical, coverage for prescription drugs, home health care, case management, and rehabilitation services. The rate of growth in the Medicaid expenditures is unsustainable and that rapidly increasing health care spending is "crowding out" spending on other public programs. About 42 percent of Americans living in poverty are not covered by Medicaid. Most of those uninsured poor do not qualify because they have no children, they are not disabled, and they are not pregnant. In a family with at least one parent working full time, only the children are eligible for coverage unless the mother is pregnant. The father is never eligible.
While Medicare covers virtually everyone over age of 65, only Americans facing severe deprivation are eligible for Medicaid. Because opinions vary widely about who most needs and deserves Medicaid, political horse trading and compromises at both the federal and state level have determined who receives coverage and who does not. The resulting rules of eligibility are mostly very complex and confusing. To deter the possibility of fraud, applying for Medicaid requires demonstrating eligibility with financial documents and passing time-consuming and cumbersome verification checks. The documentation required for such applications are mostly pay slips to utility receipts to automobile titles and so forth. Some who are eligible do not apply because of the hassles involved. Others do not apply because they are unaware that they are eligible. Because of such low rates of reimbursement to doctors discourage them from providing care to Medicaid patients. About a third of the nation's doctors limit the number of Medicaid patients they see, and a quarter reports that they will not see Medicaid patients at all. As a result, such people must rely heavily on care in clinics and hospital emergency rooms and outpatient departments.