Medicaid is Vital to a Fully Functioning Health Care System

Did you know Medicaid funding helps keep the health care system we all count on humming and providing quality care for our communities?

Medicaid is a combination state-federal program designed to help low-income families, children, and pregnant moms, as well as disabled and older people without enough resources to afford the long-term care or assistance they need. Thanks to Pennsylvania’s expansion of the Medicaid program under the Affordable Care Act, adults with incomes at or below 138 percent of the federal poverty level are also eligible for Medicaid.

Under those guidelines, a household of one could earn $12,490 a year. For a family of four, an annual income can be $25,750. For each additional person in the household, add $4,420. For smaller families, subtract $4,420 per person. The federal government adjusts the poverty level every January to account for inflation.

The state receives a matching payment from the federal government to support that expansion.

Medicaid covers one in five Americans, according to the Kaiser Family Foundation, including many with serious disabilities and complex medical needs. In Pennsylvania:

  •    Two-thirds of nursing home residents are covered by Medicaid
  •    43 percent of the Medicaid expansion population holds full- or part-time jobs—and still their incomes are low enough to qualify for the program.

Without Medicaid, many more people would be uninsured and would forgo care. Left untreated, their health problems would worsen or even become crises and would require more intensive—and more expensive—medical treatment.

Medicaid also helps our local safety net hospitals stay afloat and supports community clinics, where nationwide 76 percent of the patients either have Medicaid coverage or are uninsured, according to the journal Health Affairs.

In Pennsylvania, the state government pays for about 55 percent of the Medicaid program, and the federal government pays the remainder. Any cuts to Medicaid funding could mean cuts to services, benefits, or the health care workforce and, for many rural hospitals, that’s a danger to their very survival.

Medicaid keeps the entire health system running. It is vital to sustaining the health of our communities.