Medicaid: A Primer

Elicia J. Herz
Specialist in Health Care Financing

In existence for 45 years, Medicaid is a means-tested entitlement program that finances the delivery of primary and acute medical services as well as long-term care to more than 64 million people at an estimated annual cost to the federal and state governments of roughly $352 billion in FY2008. In comparison, the Medicare program, which provides health care benefits to 45 million seniors and certain persons with disabilities, is fully financed by the federal government, and cost nearly $461 billion in that same year. 

Each state designs and administers its own version of Medicaid under broad federal rules. State variability is the rule rather than the exception in terms of eligibility levels, covered services, and how those services are reimbursed and delivered. 

This report describes the basic elements of Medicaid, focusing on federal rules governing who is eligible, what services are covered, how the program is financed and how beneficiaries share in the cost of care, how providers are paid, and the role of special waivers in expanding eligibility and modifying benefits. Basic program statistics are also provided. Finally, recent proposed legislative changes and administrative action at the federal level that has or would affect Medicaid in significant ways is also described. .


Date of Report: February 25, 2010
Number of Pages: 17
Order Number: RL33202
Price: $29.95

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