Today, Medicaid is the nation’s primary health coverage program for low-income and high-need populations and the program serves as the foundation for coverage of the low-income population under health reform. Prior to health reform, Medicaid, together with the Children’s Health Insurance Program, offered broad based coverage to children with median eligibility levels up to 235% of poverty. However, Medicaid coverage for parents was much more limited and federal law generally prohibited Medicaid coverage for adults without dependent children. The new law bases eligibility for Medicaid on income without categorical restrictions for individuals under age 65 and establishes a national floor for Medicaid coverage at 133% of poverty ($14,404 for an individual or $29,326 for a family of four in 2009).

Since Medicaid was established in 1965, the program has gradually expanded in scope and has helped to stem greater increases in the uninsured especially among children and some parents in low-income families. Beyond coverage, Medicaid has multiple and diverse roles in today’s health care system providing health coverage to people with disabilities, long-term care coverage and financing, support to safety-net providers, and assistance to low-income Medicare beneficiaries. Medicaid is jointly funded by state the federal government.