Three programs vital to the health care security to millions of Americans celebrated birthdays last week. Medicaid and Medicare turned 47, and their “little sibling,” the Children’s Health Insurance Plan (CHIP), also marked 15 years of ensuring low-income kids have access to health insurance.
Considered to be landmark pieces of legislation in the history of health and social welfare policy, Medicare and Medicaid were signed into law in 1965 by President Lyndon B. Johnson. CHIP was signed into law in 1997 by President Bill Clinton, and provides coverage to nearly 8 million children whose families have incomes too high to qualify for Medicaid, but who lack access to affordable private coverage. Today, the programs continue to provide vital services to the most vulnerable among us.
Medicaid Medicaid is the nation’s main safety-net insurance program, covering health and long-term care services for nearly 60 million low-income Americans. Operating as a partnership between the federal government and the states, Medicaid has provided coverage and care for many of the country’s sickest and poorest people. Medicaid ensures children can see a doctor when they get sick, seniors have access to long-term care, and people with disabilities can live independent lives.
As Affordable Care Act (ACA) implementation moves forward, the program will play a huge role increasing Americans’ access to health insurance, extending coverage to as many as 16 million people.
The increase in access to care is worth celebrating, and more evidence is accruing to suggest this care translates into better outcomes. The Oregon Health Study has shown that gaining access to Medicaid makes a big difference in the lives of the newly eligible and enrolled. Additionally, a three-state study found that expanding Medicaid to low-income adults lowers mortality rates.
CHIP & Children’s Health Insurance Program Reauthorization Act (CHIPRA) Much like Medicaid, CHIP is administered by states, but jointly funded with the federal government. More recently, in 2009, the Children’s Health Insurance Program Reauthorization Act (CHIPRA) was signed, which provided funding for CHIP through 2013 and made many improvements to both the Medicaid and CHIP programs. Along with Medicaid, CHIP has helped reduce the rate of low-income uninsured children by expanding eligibility levels and simplifying enrollment procedures.
In 2008, the U.S Census Bureau reported that the uninsured rate among children was the lowest it had been since 1987. Most of these uninsured children are eligible for Medicaid and CHIP, yet not enrolled. Secretary Kathleen Sebelius issued the Connecting Kids to Coverage Challenge, calling on governors, mayors, pediatricians, community organizations, and many others to work together to cover the 5 million kids who were eligible for either CHIP/Medicaid but still not enrolled. Because of this effort, the number of eligible but unenrolled children has declined nationally.
Medicare Medicare provides federal health insurance to individuals 65 and older and those under 65 with permanent disabilities.
The ACA strengthens the Medicare program and incorporates a number of changes that will improve benefits for beneficiaries, improve the efficiency of the program, and generate savings. A number of these benefits are already being enjoyed by millions of Medicare beneficiaries (preventative services, reduced prescription drug costs and more).
Another important provision of the ACA that will strengthen Medicare is the initiative to improve care for the people who qualify for Medicare and Medicaid – the dual eligibles. Dual eligibles make up 20 percent of the Medicare population but account for 31 percent of the spending. The ACA created two new offices charged with finding ways to improve care and lower costs within the programs. The new offices have provided planning grants and new financing opportunities to help states design new programs that will better integrate Medicare and Medicaid services.
A storm on the horizonAs we celebrate the success and longevity of these programs, it is critical that they be protected and preserved to continue improving the health of Americans. We must remind policymakers who are looking to Medicare, Medicaid and CHIP to reduce the federal budget deficit that the success of these programs cannot be denied. Policymakers must protect older adults, kids, low-income families and people with disabilities by safeguarding these programs from harmful budget cuts.
— Kate Lewandowski, Senior Policy Analyst, New England Alliance for Children’s Health & Leena Sharma, State Advocacy Manager