What is Medicaid?

The outcome of the federal debate over health insurance coverage will affect many Pennsylvanians. A major issue is the future of Medicaid.

 

Medicaid is a jointly funded, federal–state health insurance program for the state’s most vulnerable citizens. In Pennsylvania, Medicaid serves approximately 2.9 million people, including children, pregnant women, seniors, individuals with disabilities, and low-income working adults.

• Nearly 2/3 of Medicaid spending goes for nursing home care for the elderly and people with disabilities
• Medicaid support allows more than 30,000 Pennsylvanians with intellectual disabilities and autism to live in their own communities
• One in three children has health insurance through Medicaid
• Medicaid funds more than 45 percent of 141,000 births in Pennsylvania
• About 565,000 Pennsylvanians receive outpatient mental health treatment through Medicaid

As part of the Affordable Care Act, Pennsylvania expanded its Medicaid program to provide more health care coverage to vulnerable people. More than 700,000 Pennsylvanians benefited.

• 43 percent of the state’s Medicaid expansion population works full or part time but makes less than the Medicaid eligibility threshold—$16,643 a year
• Many newly eligible adults suffer from significant chronic conditions. During 2015, 17 percent had a cardiovascular condition
• More than 180,000 Pennsylvanians with mental illness and substance use disorders have gained coverage due to Medicaid expansion or the Health Insurance Marketplace

Health insurance coverage gives people access to primary care doctors, vaccines, chronic disease management (diabetes, cancer, mental health), and specialists. Healthier people=healthier workers, healthier communities, and lower health care costs for everyone.