Medicaid

Welcome and Introductions

The Medicaid course introduces learners to the Medicaid program in

the United States and the ways Americans can receive federal funding
for health insurance through the Medicaid program. Learners will
participate in the following activities:
 Group presentation on Medicaid and the ways individuals receive
health insurance through the program.
 Crossword puzzle where learners research the names that different
states use for their Medicaid programs.
Course Objectives

After completing this course, you will be able to:

 Define Medicaid.
 Define the Children’s Health Insurance Program (CHIP).
 Explain how Medicaid provides health care for American Indians
and Alaskan Natives.
 Explain how the Affordable Care Act (ACA) impacted both
Medicaid and CHIP.
 Activity
For this activity, your group will be assigned one research topic on Medicaid from the
following list:
1. What is Medicaid?
2. What is the Children’s Health Insurance Program (CHIP)
3. History of Medicaid and CHIP
4. Changes to Medicaid and CHIP under the Affordable Care Act (ACA)
Use the information provided for each topic, including resources and research
subtopics, to help you create your presentation.
Use this time to gather as much information as you can about your assigned topic and
create a five-minute presentation based on that topic.
 TOPIC 1: MEDICAID

1. What is Medicaid?

Medicaid is a government program in the United States that provides free or

low-cost health insurance to people with low incomes. It helps cover medical
expenses, like doctor visits and hospital care, for those who can't afford
regular health insurance.
How is Medicaid funded?

Medicaid is funded through a combination of federal and

state money. The federal government provides a significant
portion of the funding, and each state also contributes its
share. This joint funding helps support healthcare for people
with low incomes.
Who is responsible for providing Medicaid?

Medicaid is a joint program administered by both the federal

government and individual state governments in the United
States. The federal and state governments work together to
provide and manage Medicaid benefits.
What is a Medicaid State Plan and why is it important?

A Medicaid State Plan is a document that outlines how a

specific state will run its Medicaid program, including who
is eligible, what services are covered, and how the program
is funded. It's important because it ensures consistency and
compliance with federal Medicaid guidelines while allowing
each state to tailor its program to the needs of its residents.
What are some groups that are guaranteed Medicaid coverage?

Certain groups are guaranteed Medicaid coverage, including

low-income families, pregnant women, children, and people
with disabilities. These groups typically meet the eligibility
criteria and can receive Medicaid benefits.
 What are some groups that states have the
option to provide Medicaid benefits to?

States have the option to provide Medicaid benefits to

additional groups, like low-income adults without
dependent children or people with slightly higher incomes,
but this can vary from state to state.
 What services are mandated to be
provided by Medicaid?

Medicaid is mandated to cover certain essential services,

including hospital care, doctor visits, lab tests, and some
preventive care. These services are required to be provided
to eligible Medicaid recipients.
What services do states have the option to provide

 Stateshave the option to provide additional services

through Medicaid, such as prescription drugs, dental care,
and eyeglasses, but these can vary from state to state.
 Topic 2: Children’s Health Insurance Program
(CHIP)

What is the Children’s Health Insurance Program (CHIP)?

 The Children's Health Insurance Program (CHIP) is a

government program in the United States that provides
low-cost or free health insurance for children in low-
income families who don't qualify for Medicaid. It helps
ensure that kids have access to healthcare services.
How is CHIP funded?

 CHIP is funded through a combination of federal and

state money. The federal government provides a
significant portion of the funding, and each state also
contributes its share to support healthcare for children in
low-income families.
Who does CHIP provide coverage for?

 CHIP provides health insurance coverage for children in

low-income families who do not qualify for Medicaid. It
helps ensure that these children have access to healthcare
services.
What program does CHIP work with to
provide benefits?

 CHIP works alongside Medicaid to provide benefits.

These programs, while separate, are designed to ensure
that low-income children and families have access to
affordable healthcare coverage.
What services are required to be covered by CHIP?

 CHIP is required to cover essential services, such as

doctor visits, immunizations, hospital care, and
preventive care, to ensure that children receive necessary
healthcare.
 Topic 3: Indian Health & Medicaid

What supreme court decision is considered the underlying basis

for providing federal services to members of Indian tribes?

 The underlying basis for providing federal services to members of

Indian tribes is the "Marshall Trilogy," a series of Supreme Court
decisions in the early 19th century. These decisions, including
Worcester v. Georgia and Johnson v. M'Intosh, established the legal
framework for the federal government's relationship with Native
American tribes.
What two organizations worked together to implement
Medicaid for American Indians and Alaskan Natives?

 Medicaid for American Indians and Alaskan Natives is

implemented through a collaboration between the Indian
Health Service (IHS) and the Centers for Medicare &
Medicaid Services (CMS). These organizations work
together to ensure healthcare coverage for eligible Native
American populations.
What is the Indian Health Care
Improvement Act, and what did it provide?

 TheIndian Health Care Improvement Act was a federal

law that aimed to improve healthcare services for Native
Americans and Alaskan Natives. It provided funding and
resources for the Indian Health Service (IHS) to enhance
and expand healthcare facilities and services in tribal
communities, addressing their unique healthcare needs.
How did the American Recovery & Reinvestment Act further
protect health care services provided to American Indians and
Alaskan Natives?

 The American Recovery & Reinvestment Act increased

funding for health care services for American Indians and
Alaskan Natives. It provided additional resources to
improve and maintain healthcare facilities, ensuring that
these communities had access to essential medical
services.
 Topic 4: Medicaid and the Affordable Care
Act (ACA)
What changes did the Affordable Care Act (ACA) have on both Medicaid
and CHIP?

 The Affordable Care Act (ACA) expanded both Medicaid and CHIP. It
allowed more people to qualify for Medicaid by raising income limits
and provided additional funding to strengthen and support the CHIP
program. This helped more low-income individuals and children
access affordable healthcare coverage.
Under the Affordable Care Act (ACA), how has Medicaid
changed in different states around the country?

 Under the Affordable Care Act (ACA), states had the

option to expand Medicaid to cover more low-income
individuals. However, not all states chose to expand,
leading to variations in Medicaid eligibility across the
country. Some states expanded, while others did not,
creating differences in who qualifies for Medicaid based
on where people live.
What does Medicaid now rely on to determine
eligibility under the ACA?

 Under the ACA, Medicaid eligibility relies on income,

and it uses a standardized income threshold to determine
who qualifies for coverage. This threshold is a percentage
of the federal poverty level (FPL), and it helps ensure
consistency in eligibility criteria across states that chose
to expand Medicaid.
What is the role of CMS when working with each
state’s Medicaid program?

 The Centers for Medicare & Medicaid Services (CMS)

oversees and supports each state's Medicaid program.
CMS provides guidance, funding, and regulations to help
states run their Medicaid programs effectively and in
compliance with federal standards.
What essential benefits must be provided to both adults
and children who receive Medicaid and CHIP benefits.

 Medicaid and CHIP must provide essential benefits to

both adults and children, including services like doctor
visits, hospital care, lab tests, preventive care, and
prescription drugs, ensuring that necessary healthcare is
accessible to those covered by these programs.
What bill was made permanent at the same time the ACA was
signed into law to protect the health care of American Indians
& Alaskan Natives?

 The bill made permanent alongside the ACA to

protect the healthcare of American Indians and
Alaskan Natives was the Indian Health Care
Improvement Act.
State Medicaid
Programs

Across
3. Wyoming Medicaid Program
9. Missouri Medicaid Program
7. Vermont Medicaid Program
8. Kansas Medicaid Program
Down
1) . Delaware Medicaid Program
(acronym
2. South Carolina Medicaid
Program
4. Arizona Medicaid Program
(acronym)
5. Oklahoma Medicaid Program
6. California Medicaid Program
 ANSWER
1. Delaware Medicaid Program (acronym)
-The acronym for the Delaware Medicaid Program is DMAP, which stands for
Delaware Medical Assistance Program.
2. South Carolina Medicaid Program
- The South Carolina Medicaid Program is commonly referred to by the acronym
"SCDHHS," which stands for South Carolina Department of Health and Human
Services.
3. Wyoming Medicaid Program
- The Wyoming Medicaid Program is often referred to using the acronym "WYDH" or
"WY Medicaid," which stands for Wyoming Department of Health.
4. Arizona Medicaid Program (acronym)
-The acronym for the Arizona Medicaid Program is "AHCCCS," which
stands for Arizona Health Care Cost Containment System.

5. Oklahoma Medicaid Program

-The Oklahoma Medicaid Program is commonly referred to by the acronym
"OHCA," which stands for the Oklahoma Health Care Authority.

6. California Medicaid Program

-The California Medicaid Program is referred to as "Medi-Cal," which is a
combination of "Medical" and "California." It is not typically represented
by an acronym.
7. Vermont Medicaid Program
-The Vermont Medicaid Program is often referred to as "Green
Mountain Care," and it does not have a commonly used acronym.

8. Kansas Medicaid Program

-The Kansas Medicaid Program is commonly known as "KanCare," and
it doesn't have a widely used acronym.

9. Missouri Medicaid Program

-The Missouri Medicaid Program is often referred to as "MO
HealthNet," and it doesn't have a widely used acronym.
Summary

Congratulations! You have completed the Medicaid course.

You should now be able to:
· Define Medicaid.
· Define the Children’s Health Insurance Program (CHIP).
· Explain how Medicaid provides health care for American Indians and
Alaskan Natives.
· Explain how the Affordable Care Act (ACA) impacted both Medicaid and
CHIP.