Talk:Medicaid

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Who is eligible

There is a small contradiction on who is eligible. At one pont low-income parents are mentioned but then that becomes low-income children. But the entire article makes it sound like any low-income citizen is eligible. Which is it?

"Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities."

"Medicaid is a joint federal-state program that provides health insurance coverage to low-income children, seniors and people with disabilities."

Low-income children are always eligible if they meet other requirements. In some states, some low-income parents may be eligible depending on how their program is set up. --204.113.19.8 20:39, 25 January 2007 (UTC)

...Then it would be appropriate to mention that in the article itself. The article is inconsistent with regards to the program eligibility; if there are differences in eligibility among different states, please be clear and state them.69.156.107.160 06:04, 22 February 2007 (UTC)

There's a critical issue here. Medicaid eligibility is not purely based on income, but is "categorical" - to be eligible, you can't just be poor, but you have to fall into a particular eligibility category. So, low-income children below a certain age (which mary vary by state), pregnant women, parents of Medicaid-eligible children who meet certain income requirements, low-income seniors, and low-income people who meet certain disability criteria. Each of these describes an eligible group specified by statute. If you don't fall into one of these categories - say a single young adult or childless couple who are neither disabled nor elderly - then you're not eligible for Medicaid even if your annual income is zero (or negative, for that matter). This is one significant cause for the U.S. having so many uninsured people with family incomes below the federal poverty line - they're too poor to be able to buy insurance on their own, but aren't eligible for Medicaid. (As an aside, it's interesting to think about how each of these eligibility categories play politically, and compare them to the political attractiveness of the groups that are left out.)

Piper report

Deleted link to Piper report because the link is not specific to the subject and also relates to this issue: "Adding links to one's own page is strongly discouraged." from Wikipedia:External_links#What_should_not_be_linked_to

Student at wilco

Dear Founder,

Hello to all that is reading this I found this site whan I was reasearching for Medicaid for my HOC Class. If you`re one of the many finding/reading this page add to it to help me out on M<edicaid thanks.

sincerly Noel hoc1 student at wilco

“While Medicaid and Medicare cover similar groups...”

I believe this statement is technically incorrect. From what I understand, though their target groups do, in effect, overlap in many cases, Medicaid focuses on the financially indigent while Medicare's target group is comprised of those living on a fixed income, regardless of the financial resources available to them. Kokoloko2k3 05:27, 27 Apr 2005 (UTC)

In full context, I think the article does a decent job of explaining the differences; however, I think "While Medicaid and Medicare sometimes cover similar groups..." or "While Medicaid and Medicare sometimes overlap..." would be more accurate. Edwardian 18:33, 27 Apr 2005 (UTC)

Absolutely needs to be clarified. Medicaid eligibility is based on a) low-income, and b) categories of eligibility: aged, blind, disabled, pregnant, children. Medicare is based only on age and disability, without regard for income. In reality, most Medicaid clients are children and pregnant women, and most Medicare clients are elderly. Not really an overlap, except that there are quite a few low-income elderly on both programs. Maybe it's a one-way overlap, if that makes sense - a high percentage of Medicare people are on Medicaid, but not vice versa. --204.113.19.8 20:37, 25 January 2007 (UTC)

Just to clarify, I think it's a bit inaccurate to classify those on both Medicaid and Medicare as primarily "low-income elderly." For one thing, a significant proportion of "dual-eligibles" are typically disabled non-elderly adults. But even more importantly, many elderly adults in long-term (nursing home) care are dual eligibles. While some of these adults are low-income, many are essentially middle-class. This goes to a larger point: while the public perceives Medicaid as a program for low-income children and mothers and this group does make up the largest single group of Medicaid enrollees, most of the expenditures on Medicaid go to (a) the disabled and (b) the elderly, particularly those requiring long-term care, which is essentially never covered by Medicare. While the elderly and disabled must be "low-income" to qualify for the program, they are frequently not "poor" in most meaningful senses of the word.

Copyright violations

In the introduction, the following two phrases are from http://www.cms.hhs.gov/medicaid/:

• 1) "it pays for medical assistance for certain individuals and families with low incomes and resources"
• 2) "Medicaid is the largest source of funding for medical and health-related services for people with limited income:

Any suggestions for changes? Edwardian 18:33, 27 Apr 2005 (UTC)

I don't think there's any reason to worry about these two. They are both single sentences (quotation would fall under fair use), and they're both exceedingly generic and matter-of-fact, which makes the issue of copyright rather moot. siafu 19:25, 27 Apr 2005 (UTC)

OK, it might not be a copyright violation but I do think outright copying of what someone else wrote is not proper. Edwardian 4 July 2005 04:02 (UTC)

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Just a side note: In the U.S., federal government documents and websites are not covered by copyright. By federal law, they are in the public domain. --Medinomics 4 July 2005 03:46 (UTC)

Why not? Information produced by the federal government belongs to the people. We pay for it, so we should be able to use it. That's why it's not covered by copyright. If it's well-written and factual, there's no reason not to use verbatim government wording. --204.113.19.8 20:34, 25 January 2007 (UTC)

Mandatory vs. voluntary

On 2006-04-17 at 21:30:17 (UTC) a anonymous contributor at User:137.190.236.56 replaced the following text:

State participation in Medicaid is voluntary; however, all states have participated since 1982. In some states Medicaid pays private health insurance companies that contract with the state Medicaid program, while other states pay providers (i.e., doctors, clinics and hospitals) directly to ensure that individuals receive proper medical attention. The State Children's Health Insurance Program (SCHIP) was established in 1997.

...with this text:

It is a mandatory joint federal and state program in which federal and state support are ashated based on the state's per capita income (pg.258 Health Care USA: Fourth Edition, Sultz and Young).

I have reverted the article to the earlier text, but have included the edit here in order to open a discussion of this topic.

In my review of the material put out by CMS, the issue of mandatory vs. voluntary are found in descriptions of (1) benefits offered and (2) beneficiaries covered, but not (3) whether a state can opt-out of Medicaid, which appears to be the focus of this edit. The fact is that Medicaid is available in all states, and no state is currently trying to withdraw from the overall program, so it seems that the discussion of forced participation by states is really a moot point, unless a state attempts to completely withdraw from the Medicaid program. As a practical matter this is unlikely to happen, given the strong incentive provided by matching federal dollars.

As the edit removed other useful information (everything after the first sentence) which does not directly related to this topic, I'm inclined leave out this last contribution. Thanks, -- Argon233 ^T C U _@ ¶ ∠  23:06, 17 April 2006 (UTC) Bold text

Actually, states can opt out of Medicaid. Someone should change the text back to reflect this. --204.113.19.8 20:32, 25 January 2007 (UTC)

universal healthcare

are there any resources out there that can compare the medicaid in the u.s. vs a universal healthcare programme such as those seen in canada or england? in terms of the quality of care.

I can answer the question about how medicaid compares to Canada, or Britain. Medicaid offers superior coverage. There is no copay, and the medicine costs $1. Medicaid pays private insurers like Kaiser. All of the service you recieve will be private, the same as paying out of your pocket. This means that the system won't be backed up like you would see in Canada, Britain, or Europe. Instead of waiting one year to see a specialist, you will get treated much faster under medicaid than you would in Canada. Medicaid is probably the best healthcare you can get anywhere in the world.