1. 2 |Read the text and answer the questions.

1. What groups of population does Medicaid provide health care ser­vices for?

2. How is Medicaid financed?

3. How is Medicaid eligibility determined?

4. What services does Medicaid pay for?

5. What are the advantages and disadvantages of Medicaid program?

Medicaid

Medicaid, a joint federal-state program, is usually operated by state welfare or health departments. Medicaid furnishes at least five basic services to needy persons: inpatient hospital care, outpatient hospital care, physicians’ services, skilled nursing-home services for adults, and laboratory and X-ray services. The people who are eligible include fam­ilies and certain children who qualify for public assistance and may include aged, blind, and disabled adults who are eligible for the Supple­mental Security Income program of the Social Security Administration. States may also include persons and families termed “medically needy” who meet eligibility requirements exccpt those for financial assistance. Each state decides who is eligible for Medicaid benefits and what ser­vices will be included. Some of the benefits frequently provided arc dental care; ambulance services; and the cost of drugs, eyeglasses, and hearing aids. In determining eligibility for the program, a state may not hold adult children responsible for medical expenses of their parents.

All the states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands operate Medicaid plans.

Who is eligible for Medicaid? — Eligibility for Medicaid is deter­mined by states within broad federal guidelines. Uniformly, states must cover certain persons who are poor, aged, blind, disabled, or pregnant or are either a child or the parent of a dependent child.

On a national basis, Medicaid covered nearly 50 % of Americans younger than 65 years below the federal poverty level. Individuals younger than 65 years who are not pregnant and have no children or disabilities do not qualify for Medicaid, no matter how poor they arc

or how high their medical expenses are. The share of the poor covered by Medicaid is expected to reach 58 %.

How is Medicaid financed? — Federal and state governments joint­ly finance Medicaid. Some states, such as New York and California, require local government contributions toward the state share. The federal government matches state spending on a sliding scale based on state per capita income. States with high per capita income, like New York, receive a 50 % federal match rate. States with low per capita income, like Mississippi, receive a higher federal match rate, up to 80 %. The national average federal match rate is 57 %.

What services does Medicaid pay for? — Because Medicaid is in­tended to provide access to health services for those in poverty, it covers broad range of preventive, acute, and long-term care services with few or no cost-sharing requirements. States determine limits on the amount, duration, and scope of covered services. Federal statute requires states to cover inpatient and outpatient hospital services; phy­sicians, midwife, and nurse practitioner services; laboratory, X-ray, nursing home, home health care, and family planning services; and early and periodic screening, detection, and treatment for children. The early and periodic screening, detection, and treatment require­ment covers preventive services and attempts to detcct and treat con­ditions early to mitigate disability in later years.