Politics

Medicaid and health care reform

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The Medicaid program provides healthcare coverage for the poor and the disabled, and the federal government splits the cost with states; but states largely decide who and what services are covered.

For example, in Alabama, a family of four qualifies for Medicaid if they earn less than $2,400; in Minnesota, families can potentially receive Medicaid if they earn less than $60,000.

Karen Tumulty is covering health care reform for "Time" magazine. She says many people don't really understand Medicaid.

"The Medicaid program was established back in the 1960s, right alongside the Medicare program; but people really don't understand what it is, said Tumuly. "They think it's a health care program for the poor; but the fact is that in many, many states, to qualify for Medicaid you have to be poor and something else. You have to be poor and disabled; you have to be poor and pregnant; poor and elderly; or poor and with children."

Most poor children get medical coverage under Medicaid; but their parents are another story. States use a percentage of the federal poverty level -- that's $22,000 a year for a family of four -- to base their calculation for eligibility.

In Texas, families have to make less than 13 percent of the poverty level to qualify; but in Main, New Jersey and Wisconsin, they have to make less than 200 percent of the poverty level.

According to Tumulty, the House and Senate are currently looking into making the Medicaid into a "true poverty program."

"A program that would actually be based for the first time on income alone. You would qualify for Medicaid across the country if you made 133 percent of poverty.

"And for the first time, single adults who are not disabled, who are not elderly, would be guaranteed access to the Medicaid program if their income was below a certain level. This is a fundamental change in the way this country has approached the Medicaid program."

States are balking over this change as a big portion of the cost would go to them.

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