Also, states are encouraged to employ the waiver authority to test alternative service delivery approaches.

All 50 states, the District of Columbia, and the territories have CHIP plans.The 2010 Affordable Care Act (ACA) brought the Health Insurance Marketplace, a single place where consumers can apply for and enroll in private health insurance plans. However, as emphasized in "handbook.pdf"

Most recently, states have been allowed to employ the Section 1115 waiver authority to extend services on a targeted basis to low-income uninsured individuals and families who would otherwise not qualify for Medicaid.

It also made new ways for us to design and test how to pay for and deliver health care.


Many of these children came from uninsured working families that earned too much to be eligible for Medicaid.



Medicaid (Title XIX of the Social Security Act) was created in 1965 in tandem with the Medicare program (Title XVIII).

3 The Medicare program is a federally funded and administered health insurance program for retirees, disabled workers, and their spouses and dependents.

The federal government would make payments to states to pay for half or more of their costs in furnishing services to beneficiaries. The original Medicare program included Part A (Hospital Insurance) and Part B (Medical Insurance).


Medicaid is a joint federal-state program that provides health coverage or nursing home coverage to certain categories of low-asset people, including children, pregnant women, parents of eligible children, people with disabilities and elderly needing nursing home care. In the Balanced Budget Act of 1997, Congress gave states new options to implement managed care approaches without having to seek special waivers.

In 1996, about 40 percent of Medicaid beneficiaries nationwide were enrolled in managed care; by 2003, the figure had climbed to more than 59 percent.

Medicaid was designed to expand access to “mainstream” health care for low-income individuals and families. In addition, Medicaid has become the dominant funder of long-term services for people with disabilities. The original Medicare program included Part A (Hospital Insurance) and Part B (Medical Insurance).

COVERED: a week-by-week look at the political and legislative developments that led to the creation of Medicare and Medicaid 50 years ago.Bob Rosenblatt, Academy senior fellow and former Los Angeles Times Washington correspondent will report on the people and the maneuvers that led to this major expansion of social insurance.



Medicaid (Title XIX of the Social Security Act) was created in 1965 in tandem with the Medicare program (Title XVIII). Medicare and Medicaid was created by congress in 1965 under the social security act and signed into law by President Lyndon B. Johnson. Assistant Secretary for Planning and Evaluation, Room 415F The cumulative effect of these changes -- combined with state decisions regarding the scope of their programs -- has been to expand Medicaid well beyond its original focus on furnishing principally acute care services to public assistance recipients.

Medicaid Services. Under the MMA, private health plans approved by Medicare became known as Medicare Advantage Plans. But there are major differences.

However, the effect of most changes has been to expand the options available to states in designing and administering their Medicaid program. These plans are sometimes called "Part C" or "MA Plans.”The MMA also expanded Medicare to include an optional prescription drug benefit, “Part D,” which went into effect in 2006.The Children’s Health Insurance Program (CHIP) was created in 1997 to give health insurance and preventive care to nearly 11 million, or 1 in 7, uninsured American children. Today these 2 parts are called “Original Medicare.” Over the years, Congress has made changes to Medicare:For example, in 1972, Medicare was expanded to cover the disabled, people with end-stage renal disease (ESRD) requiring dialysis or kidney transplant, and people 65 or older that select Medicare coverage.At first, Medicaid gave medical insurance to people getting cash assistance. The combination of Medicaid mandates and options has resulted in the emergence of 51 highly distinctive Medicaid programs that operate under broad national guidelines but have been shaped by state decisions about who is eligible and what they are eligible to receive. Both were signed into law in 1965.

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