Social Security Medicaid
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Medicaid is a federal-state program to provide medical assistance to low-income families who meet specific requirements. The origin of Medicaid is in the “Aid to Families with Dependent Children” and “Supplemental Security Income” programs. This emphasis is apparent in the categories of individuals that are eligible for the program. Low-income families with children, elderly and disabled individuals are the main ones that are eligible for services. This is a means tested program, meaning that there are a lot of rules regarding income and resources. The eligibility policy is used to minimize the state and federal governments cost of providing covered benefits. This program targets groups that have higher than average medical care costs.
State discretion
States have a lot of choice regarding eligibility for Medicaid. Since each state has a lot of control over eligibility there are significant differences in each states policies. Funding for Medicaid is flexible and the matching federal funds are open ended. States are using the flexibility to provide coverage to Americans that would otherwise go uninsured. Since Medicaid is not a uniform federal program like Medicare, the states have a wide range of eligibility criteria. Most states do not provide funding for individuals not eligible under federal guidelines because they would then bear the full financial weight of those programs.
Federal eligibility
Federal matching funds can only be used for specific categories of low-income individuals. Adults with disabilities and the elderly have some eligibility while the childless and adults under the age of 65 who are not disabled are not eligible for federal funding. Federal guidelines determine states eligibility options. A person must meet all financial and non-financial requirements to qualify for Medicaid.
Financial eligibility
There are two areas involving finances that have federal rules governing state policies. One is income and the other is resources. Because this program is based on financial need these requirements must be met as well as the non-financial requirements. For most of the categories the income requirement is tied directly to a percentage of the federal poverty level. For categories such as nursing homes it is tied to the federal cash assistance program. In most cases resource requirements are specific dollar amounts. There are rules that affect the standard of dollar amounts and each individual state decides how that is determined.
Non Financial eligibility
Three of the five broad federal requirements are category, immigration status, and residency. There are 25 different categories for eligibility. These break down into 5 major categories, which are children, pregnant women, adults in families with dependent children, disabled and elderly. There are some categories that are based on a specific disease. Immigration status eligibility can loosely be defined as non-legal and legal. Legal immigrants with less than 5 years residency are not eligible, regardless of finances except in an emergency. Residency is being a citizen of the United States and a resident of the state providing services. There are many variables regarding category. Just because there is matching federal funds available does not mean that the individual state has to provide the service. Each state has the option of choosing which categories of services, covered by federal funds, they will provide.
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