In this first chapter to its inaugural 2011 report, MACPAC describes how Medicaid has evolved from welfare-based coverage to a major source of coverage in our health care system, while the State Children’s Health Insurance Program (CHIP) provides coverage to children in low-income, mostly working, families. Medicaid’s role in our health care delivery system is unique: the program covers the diverse health needs of enrollees; directly supports safety-net providers; covers long-term services and supports for low-income Medicare beneficiaries; and reduces uncompensated care. Incremental additions and changes have been layered on top of Medicaid’s original foundation, expanding the scope of whom the program serves, what it provides, and its costs.
Federal and state Medicaid officials share responsibility for administering Medicaid and CHIP, including providing enrollees appropriate access to care; maintaining coverage of people and benefits during economic downturns; ensuring adequate provider participation; coordinating care with Medicare for low-income elderly and disabled; and containing costs while meeting diverse, complex, and costly health care needs. At the same time, program managers must maintain program integrity and fiscal accountability. Read more about Medicaid and CHIP, their history, and their context in the U.S. health care system.
From: March 2011 Report to the Congress on Medicaid and CHIP