The Medicaid program is the nation’s public health insurance program for low-income people and it plays a major role in our health care system. The program covers nearly 60 million Americans.
The Medicare and Medicaid programs collectively represent the largest sources of care for people living with HIV/AIDS in the United States.
The Medicaid program is run by the Centers for Medicare and Medicaid Services (CMS), under The Department of Health and Human Services (HHS).
Medicaid is estimated to be the single largest source of coverage for people with HIV in the U.S. While Medicaid enrollees with HIV represent less than 1% of the overall Medicaid population, they account for almost half of people with HIV in regular care.
HHS estimates that in FY 2010, 62% of the overall expenditures on domestic HIV/AIDS funding was through the CMS.
Medicaid is the third largest domestic program in the federal budget, after Social Security and Medicare. It is also the second largest programs in most state budgets. The federal government matches state spending in Medicaid, paying for 56% of the program’s spending overall.
The Medicaid program varies from state to state. It funds care through many hospitals, nursing homes, clinics, pharmacies, and providers.
There is significant variation across states in terms of eligibility criteria, benefits packages, and other aspects of the program.
The Medicaid program works counter-cyclically to the economy, expanding during times of recession to assist millions of individuals and families affected by the loss of jobs and job-based health insurance.
In recent years, economic conditions have contributed to growing numbers of individuals accessing the program. This growth in the number of individuals accessing the program for the program places additional pressure on state budgets and Medicaid funding.
Some states have tried to mitigate these costs through contracting with managed-care type programs, and implementation of other efforts to reduce programmatic costs. These efforts have in some cases left people with HIV on Medicaid with insufficient access to care and treatment. Learn more about what is happening in The States.
Congress has also considered efforts to scale back the program through budgets cuts at the federal level in recent years, in attempts to balance the federal budget and reduce to national deficit. Learn more about Federal Funding.
The “Affordable Care Act” (ACA) passed in 2010, provided for significant changes to the Medicaid program. It created several new initiatives and opportunities for states under traditional Medicaid. It also provided for the single largest expansion of the program in its history. Learn more about Medicaid & Health Reform or the Medicaid Expansion. As the number of people eligible for Medicaid grows, HRSA continues to work toward increased coordination between Medicaid and the Ryan White Program.
AAHIVM’s Advocacy Efforts
To learn about AAHIVM’s advocacy efforts on behalf of our members during the law’s development, or since its passage, visit Our Advocacy Efforts – Medicaid page
To get more involved in the decisions being made about the law’s implementation, visit our Take Action – Medicaid page.