It’s time to take control of Medicaid before it takes control of us. Unless we act — and there is little evidence that we will — Medicaid increasingly becomes another mechanism by which government skews spending toward the old and away from the young. In the raging debate over the Affordable Care Act (Obamacare), this is a subject that neither Republicans nor Democrats dare touch. It’s an ominous omission that obscures the overhaul Medicaid really needs.
Medicaid is the sleeping giant of U.S. health care. Created in 1965, it provides health insurance for the very poor. Here are some basic Medicaid facts:
● It is the nation’s largest health insurance program by beneficiaries, with 68 million recipients compared with Medicare’s 55 million. (Medicare provides insurance for the 65 and over population.)
● Medicaid’s costs are shared between the federal government (roughly 60 percent) and state governments (40 percent). In 2015, Medicaid spending totaled $545 billion compared with Medicare’s $646 billion, reports the Kaiser Family Foundation.
● Although the Obamacare debate has focused on private insurance subsidized through health exchanges, the expansion of Medicaid — adopting more liberal eligibility requirements — resulted in the largest gain of insurance coverage, about 11 million people.