Medicaid at 50: Strengthening and Sustaining the Program

In July of 2015, Medicaid turned 50 years old. It was created as a joint Federal/State program to provide healthcare coverage to certain categories of low-income Americans. Today Medicaid is the largest health insurance program in the world. More than 70 million Americans are covered by Medicaid, which is more than are covered by Medicare. Medicaid is a critical lifeline for some of our Nation's most vulnerable patients. Medicaid provides health care for children, pregnant mothers, the elderly, the blind, and the disabled. The current trajectory of Medicaid spending is problematic. Since 2003 Medicaid has been designated a high risk program by the GAO because of its size, growth, diversity programs, concerns about gaps, and fiscal oversight. In the next decade, program outlays are set to double. That means that, in a decade, Medicaid is going to cost Federal taxpayers what Medicare costs today. And that is not even counting the fact that the Medicaid program is already the fastest growing spending item in most State budgets. Without Congressional intervention, Medicaid will continue to consume a larger and larger portion of Federal and State spending. According to CBO data, by 2030, the entire Federal budget will be consumed with spending on mandatory entitlements and service on the debt. This spending trajectory threatens the quality and access of care for the millions of vulnerable patients who depend on Medicaid.