Medicare and Medicaid Celebrate Impact, Look Toward Future on 50th Anniversary

July 30, 2015, marked 50 years since President Lyndon B. Johnson signed an amendment to the Social Security Act that made Medicare and Medicaid law. Since then, the number of uninsured Americans 65 and older has dropped from 48 percent to just 2 percent. Medicare now covers approximately 55 million Americans: the single largest provider of health insurance coverage in the country.

Medicaid, too, continues to expand as individual states opt into the federal Medicaid funds offered by the Affordable Care Act. Thirty-one states have expanded their Medicaid programs since 2010, providing healthcare coverage to adults under the age of 65 whose incomes are equal to or less than 138 percent of the federal poverty level

While much has changed in the landscape of American healthcare in the last five years, there is still room for improvement. According to a recent Kaiser Family Foundation poll on Medicare and Medicaid, nearly 40 percent of those with Medicaid and 20 percent of those with Medicare experience problems with coverage or finding providers. Furthermore, a number of Medicare and Medicaid enrollees report financial hardships as a result of their healthcare costs, forcing them to spend less on food, heat and other basic needs.

In addition, Medicare itself now faces financial challenges, and is reforming its payment structure. One of the ways Medicare will do so is by transitioning away from its fee-for-service payment model and moving toward alternate quality-based payment models. Additionally, the Center for Medicare & Medicaid Services (CMS) is pushing providers to better coordinate care – requiring physicians, hospitals and other healthcare providers to work together – and determining compensation based on improved patient outcomes.

With this in mind, PHA is committed to monitoring individual experiences and working with CMS to provide quality access to care for all PHers. If you are experiencing difficulties in attaining health coverage or are having problems with your Medicare or Medicaid, please contact Tim at Insurance@PHAssociation.org or 301-565-3004 x773.