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Take the Medicaid quiz
08:24 AM CDT on Thursday, July 2, 2009
WASHINGTON – Because of its size and cost, Medicaid has been called the "workhorse" of the U.S. health system. Now it's front and center in the debate on overhauling the U.S. health system and expanding coverage to the uninsured.
With 60 million enrollees, Medicaid dwarfs other insurance programs, including its cousin, Medicare, which covers 44 million elderly and disabled people. As part of efforts to extend health coverage to millions of uninsured Americans, congressional Democrats are pressing for a major expansion in the state-federal program for the poor and disabled.
Test your knowledge of Medicaid with these statements and explanations, compiled by Kaiser Health News, a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization. Medicaid is a national program of the federal government.
Partly true. It's a joint federal-state program, with the federal government picking up 50 percent to 73 percent of the overall Medicaid tab, with poorer states getting a bigger matching rate. After meeting certain federal requirements, each state has the flexibility to shape coverage and benefits.
If you're poor enough, Medicaid will cover your health care needs.
False. Medicaid covers about 45 percent of poor Americans, defined as those with incomes below the federal poverty level (about $22,000 for a family of four in 2009). To be eligible, individuals must fall below certain income thresholds, which vary by state, and belong to certain categories, such as having dependent children, or being pregnant or disabled.
Medicaid provides bare-bones coverage compared with what's available in the private sector.
False. Benefits include mental health services, transportation to health services, and comprehensive screenings and treatment for children. Medicaid enrollees have much lower out-of-pocket costs than people with private coverage. There are typically no monthly premiums and no, or very low, co-payments.
Medicaid is accepted by all providers.
False. In many states, specialists and dentists don't see Medicaid patients. Providers typically blame low reimbursement rates as the main reason for not accepting Medicaid patients.
Most Medicaid spending pays for services for children and their parents.
False. About three-quarters of Medicaid spending is for the elderly and disabled, even though the two groups make up only about one quarter of the program's enrollees. Medicare provides little coverage for long-term care, so many elderly, after depleting their savings, rely on Medicaid to pay their costly nursing home bills.
Medicaid is more efficient than private insurance.
True. Administrative costs of Medicaid are less than 7 percent, or half the rate that's typically seen in the private sector. Medicaid holds down costs in part because it pays providers lower fees and does little marketing.
McClatchy Newspapers
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