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Medicaid at 50

Fifty years ago today, President Lyndon B. Johnson signed into law the act that created the Medicaid program.  Today, Medicaid serves as a critical health safety net for low-income elderly people, people with disabilities, children, and some very low-income parents — all of whom face challenges in accessing insurance through the traditional health market.  In 1997, the Children’s Health Insurance Program (CHIP) was created, which allowed Nebraska and other states to extend their Medicaid programs to cover more low-income kids.  Today, about 30% of Nebraska kids receive health insurance through Medicaid and CHIP.  We know that kids without health insurance are less likely to access preventive care and without Medicaid and CHIP we would be missing critical opportunities to help ensure that children get a strong and healthy start to life.

One of the biggest misconceptions about our Medicaid program is who is currently covered.  In Nebraska, the majority of Medicaid recipients are kids, followed by the blind and disabled, low-income parents and the elderly.  Although kids make up the majority of those covered, they make up less than 30 percent of the overall program costs.

Research has shown that the (comparatively) small investment we make in children’s health through Medicaid and CHIP pays significant dividends in the long run, in the form of better health and educational outcomes for kids.  At 50,  this is a legacy that Medicaid can be proud of.

As we highlight the program’s accomplishments to date, we can also look to the future of the program.   Here are some questions about the program’s future for kids that still need to be adressed:

1) What is the future of CHIP?  CHIP was recently reauthorized by Congress for two years, but the short-term re-authorization in the context of a changing health care landscape leave questions about whether this critical program for kids will remain strong in the future.

2) How do we leverage Medicaid, CHIP and the Affordable Care Act to ensure all kids have health insurance coverage?  About 67% of uninsured kids in Nebraska are income-eligible for Medicaid or CHIP.  How do we ensure that these program is reaching all who need it?

3) Will Nebraska join the 30 other states in extending the Medicaid program to more low-income parents and single adults?  The Supreme Court decision leaving the option to expand Medicaid to states has left a significant gap in health insurance access for many Nebraskans, including some low-income parents.  We know that kids benefits when parents have access to health insurance, and how Nebraska deals with the coverage gap will have an impact on families.

At the age of 50, Medicaid has given us much to be proud of, especially in ensuring health care access for low-income kids.  Like any aging program, questions remain about the future and how the country and state address these questions undoubtedly have an impact on our children’s health.


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