Welfare in California consists of federal welfare programs—which are often at least partially administered by state and county agencies—and several independent programs, which are usually administered by counties.
70-813: Some of the largest California-specific programs are: The California Medical Assistance Program (Medi-Cal) is California's Medicaid program serving low-income families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level. Benefits include doctor's office visits, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder treatment, dental care (Denti-Cal), vision care, and long-term care and support. Approximately 13.6 million people were enrolled in Medi-Cal as of August 2021, or about 34.6% of California's population. The California Work Opportunities and Responsibility to Kids (CalWORKs) program
140-544: A "free appropriate public education" under Section 504 of The Rehabilitation Act of 1973. Decisions by the United States Supreme Court and subsequent changes in federal law require states to reimburse part or all of the cost of some services provided by schools for Medicaid-eligible disabled children. The Affordable Care Act (ACA), passed in 2010, substantially expanded the Medicaid program. Before
210-488: A 0.2 percentage point reduction in poverty is attributed to TANF (of which CalWORKs is a part). Medicaid In the United States , Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but
280-501: A combination of education and training services to prepare individuals for work and to help them improve their prospects in the labor market. In the broadest sense, workforce development efforts include secondary and postsecondary education, on-the-job and employer-provided training, and the publicly funded system of job training and employment services. Title I of the 2014 Workforce Innovation and Opportunity Act authorizes programs to provide employment and training services, and establishes
350-505: A program called Access to Baby and Child Dentistry (ABCD) has helped increase access to dental services by providing dentists higher reimbursements for oral health education and preventive and restorative services for children. After the passing of the Affordable Care Act , many dental practices began using dental service organizations to provide business management and support, allowing practices to minimize costs and pass
420-588: A significant proportion of Medicaid enrollees. As of 2014, 26 states have contracts with managed care organizations (MCOs) to deliver long-term care for the elderly and individuals with disabilities. The states pay a monthly capitated rate per member to the MCOs, which in turn provide comprehensive care and accept the risk of managing total costs. Nationwide, roughly 80% of Medicaid enrollees are enrolled in managed care plans. Core eligibility groups of low-income families are most likely to be enrolled in managed care, while
490-497: Is 20%, but if welfare benefits were excluded from the estimates of families' resources that would rise to 28%. In other words, one third of the people who would be in poverty if welfare programs didn't exist are raised "out" of poverty by welfare programs. About a quarter of that effect (2 percentage points reduction in the CPM poverty rate) is due to CalFresh , and another quarter is due to earned income tax credits (the federal EITC and
560-505: Is a mandatory Medicaid program for children that focuses on prevention, early diagnosis and treatment of medical conditions. Oral screenings are not required for EPSDT recipients, and they do not suffice as a direct dental referral. If a condition requiring treatment is discovered during an oral screening, the state is responsible for paying for this service, regardless of whether or not it is covered on that particular Medicaid plan. Children enrolled in Medicaid are individually entitled under
630-403: Is a program that is not solely funded at the federal level. States provide up to half of the funding for Medicaid. In some states, counties also contribute funds. Unlike Medicare, Medicaid is a means-tested , needs-based social welfare or social protection program rather than a social insurance program. Eligibility is determined largely by income. The main criterion for Medicaid eligibility
700-401: Is a universal program providing health coverage for the elderly. Medicaid offers elder care benefits not normally covered by Medicare, including nursing home care and personal care services. There are also dual health plans for people who have both Medicaid and Medicare. Along with Medicare, Tricare , and ChampVA , Medicaid is one of the four government-sponsored medical insurance programs in
770-528: Is defined vary from state to state. As of 2019, when Medicaid has been expanded under the PPACA, eligibility is determined by an income test using Modified Adjusted Gross Income , with no state-specific variations and a prohibition on asset or resource tests. While Medicaid expansion available to adults under the PPACA mandates a standard income-based test without asset or resource tests, other eligibility criteria such as assets may apply when eligible outside of
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#1732781123209840-413: Is largely consistent by state, and requirements on how to qualify or what benefits are provided are standard. However AFDC has differing eligibility standards that depend on: Beyond the variance in eligibility and coverage between states, there is a large variance in the reimbursements Medicaid offers to care providers; the clearest examples of this are common orthopedic procedures . For instance, in 2013,
910-626: Is limited income and financial resources, a criterion which plays no role in determining Medicare coverage. Medicaid covers a wider range of health care services than Medicare. Some people are eligible for both Medicaid and Medicare and are known as Medicare dual eligible or medi-medi's. In 2001, about 6.5 million people were enrolled in both Medicare and Medicaid. In 2013, approximately 9 million people qualified for Medicare and Medicaid. There are two general types of Medicaid coverage. "Community Medicaid" helps people who have little or no medical insurance. Medicaid nursing home coverage helps pay for
980-623: Is the California implementation of the federal welfare-to-work Temporary Assistance for Needy Families (TANF) program that gives cash aid and services to eligible needy California families. CalFresh is the California implementation of the federal Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp program, which provides financial assistance for purchasing food for those in poverty in California. The State Supplementation Program (SSP or SSI/SSP), also known as
1050-543: Is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; in 2019, the program paid for half of all U.S. births. As of 2017, the total annual cost of Medicaid was just over $ 600 billion, of which the federal government contributed $ 375 billion and states an additional $ 230 billion. States are not required to participate in
1120-531: Is worse than that of people with higher income. The Census Bureau reported in September 2019 that states that expanded Medicaid under ACA had considerably lower uninsured rates than states that did not. For example, for adults between 100% and 399% of poverty level, the uninsured rate in 2018 was 12.7% in expansion states and 21.2% in non-expansion states. Of the 14 states with uninsured rates of 10% or greater, 11 had not expanded Medicaid. A July 2019 study by
1190-837: The "one-stop" delivery system . In California, the Governor , California Workforce Development Board , Employment Development Department and local workforce development boards administer the program. The Statewide Automated Welfare System (SAWS) is the county-managed public assistance eligibility and enrollment system, e.g., the case management system for county eligibility staff providing CalWORKs, Welfare to Work, CalFresh, Medi-Cal, Foster Care, Refugee Assistance, County Medical Services Program, and General Assistance/General Relief. Counties are organized into three SAWS consortia ( joint powers authorities ): C-IV (Consortium-IV), WCDS ( CalWIN ), and Los Angeles County's LEADER Replacement System (LRS). LRS began deployment on February 23, 2016 and
1260-410: The 2008–2009 recession resulted in a substantial increase in Medicaid enrollment in 2009. Nine U.S. states showed an increase in enrollment of 15% or more, putting a heavy strain on state budgets. The Kaiser Family Foundation reported that for 2013, Medicaid recipients were 40% white, 21% black, 25% Hispanic, and 14% other races. Unlike Medicaid, Medicare is a social insurance program funded at
1330-536: The Supplemental Security Income (SSI) program for the aged, blind and disabled. States are required under federal law to provide all AFDC and SSI recipients with Medicaid coverage. Because eligibility for AFDC and SSI essentially guarantees Medicaid coverage, examining eligibility/coverage differences per state in AFDC and SSI is an accurate way to assess Medicaid differences as well. SSI coverage
1400-454: The "aged" and "disabled" eligibility groups more often remain in traditional " fee for service " Medicaid. Because service level costs vary depending on the care and needs of the enrolled, a cost per person average is only a rough measure of actual cost of care. The annual cost of care will vary state to state depending on state approved Medicaid benefits, as well as the state specific care costs. A 2014 Kaiser Family Foundation report estimates
1470-471: The "provision of general assistance is inconsistent, fragmented, and widely differentiated", with aid ranging from $ 160 per month in Santa Barbara County to $ 360 in neighboring Ventura County . In Orange County , aid was $ 277 per month as of July 2012 and capped at three months per 12-month period for residents deemed employable. California has provided some form of general assistance since
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#17327811232091540-510: The 10% contribution in 2020. Some studies suggested that rejecting the expansion would cost more due to increased spending on uncompensated emergency care that otherwise would have been partially paid for by Medicaid coverage. A 2016 study found that residents of Kentucky and Arkansas , which both expanded Medicaid, were more likely to receive health care services and less likely to incur emergency room costs or have trouble paying their medical bills. Residents of Texas , which did not accept
1610-416: The 1980s, many states received waivers from the federal government to create Medicaid managed care programs. Under managed care, Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. The health plan is then responsible for providing for all or most of the recipient's healthcare needs. Today, all but a few states use managed care to provide coverage to
1680-474: The Affordable Care Act was a federally-funded increase in 2013 and 2014 in Medicaid payments to bring them up to 100% of equivalent Medicare payments, in an effort to increase provider participation. Most states did not subsequently continue this provision. In 2002, Medicaid enrollees numbered 39.9 million Americans, with the largest group being children (18.4 million or 46%). From 2000 to 2012,
1750-617: The Federal government, although states would need to pay for 10% of those costs by 2020. However, in 2012, the Supreme Court held in National Federation of Independent Business v. Sebelius that withdrawing all Medicaid funding from states that refused to expand eligibility was unconstitutionally coercive. States could choose to maintain pre-existing levels of Medicaid funding and eligibility, and some did; over half
1820-975: The HFP into Medi-Cal beginning in 2013. The Medi-Cal Access Program (formerly known as the Access for Infants and Mothers Program) provides low-cost health insurance coverage to middle-income pregnant women who don't already have health insurance and whose income is too high to qualify for Medi-Cal. Since 1933, California law has required counties to provide relief to the poor, including health care services and general assistance. The California Welfare and Institutions Code states: Every county and every city and county shall relieve and support all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, lawfully resident therein, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions. It has been said that
1890-645: The Housing Act of 1937 and created Section 8 housing , now known as the Housing Choice Voucher program. The California Department of Housing and Community Development (HCD) Housing Assistance Program (HAP) acts as the local housing authority for 12 rural counties: Alpine , Amador , Calaveras , Colusa , Glenn , Inyo , Modoc , Mono , Sierra , Siskiyou , Trinity , and Tuolumne . Some other examples of local and area housing authorities include the: Workforce development programs provide
1960-529: The LRS contract and the creation of a new consortium to replace the LEADER and C-IV consortia. While the long-term effect of these programs on California as a whole is multi-faceted and complex, the immediate effect on those receiving aid is somewhat easier to quantify. The resources available to each Californian (i.e. their income, accounting for taxes and benefits such as medical care) can be compared to an estimate of
2030-736: The Medicaid expansion, did not see a similar improvement during the same period. Kentucky opted for increased managed care, while Arkansas subsidized private insurance. Later, Arkansas and Kentucky governors proposed reducing or modifying their programs. From 2013 to 2015, the uninsured rate dropped from 42% to 14% in Arkansas and from 40% to 9% in Kentucky, compared with 39% to 32% in Texas. A 2016 DHHS study found that states that expanded Medicaid had lower premiums on exchange policies because they had fewer low-income enrollees, whose health, on average,
2100-567: The National Bureau of Economic Research (NBER) indicated that states enacting Medicaid expansion exhibited statistically significant reductions in mortality rates. The ACA was structured with the assumption that Medicaid would cover anyone making less than 133% of the Federal poverty level throughout the United States; as a result, premium tax credits are only available to individuals buying private health insurance through exchanges if they make more than that amount. This has given rise to
2170-461: The PPACA expansion, including coverage for eligible seniors or disabled. These other requirements include, but are not limited to, assets, age, pregnancy, disability, blindness, income, and resources, and one's status as a U.S. citizen or a lawfully admitted immigrant . As of 2015, asset tests varied; for example, eight states did not have an asset test for a buy-in available to working people with disabilities, and one state had no asset test for
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2240-622: The Social Security Act of 1935 and became effective on January 1, 1991. This program was formed due to the costs that Medicaid programs were paying for discount price outpatient drugs. The Omnibus Budget Reconciliation Act of 1993 (OBRA-93) amended Section 1927 of the Act, bringing changes to the Medicaid Drug Rebate Program. It requires states to implement a Medicaid estate recovery program to recover from
2310-545: The Supplemental Nutrition Assistance Program (SNAP, CalFresh) cash-out program, is the state supplement to the federal Supplemental Security Income (SSI) program and provides state-funded supplemental food benefits to SSI recipients in lieu of SNAP benefits. SSI recipients in states that provide state supplements to SSI are ineligible for SNAP/CalFresh pursuant to 7 U.S.C. § 2015(g) . The Healthy Families Program (HFP)
2380-654: The U.S. government to local public housing agencies (LHA's) to improve living conditions for low-income families. On 21 March 1938 Governor Frank Merriam signed multiple laws including the Housing Authorities Law and the Housing Cooperation Law that establishes a housing authority in every city and county in California and allows for the establishment of joint powers area housing authorities. The Housing and Community Development Act of 1974 signed by President Gerald Ford later amended
2450-972: The United States. The U.S. Centers for Medicare & Medicaid Services in Baltimore , Maryland provides federal oversight. Research shows that existence of the Medicaid program improves health outcomes, health insurance coverage, access to health care, and recipients' financial security and provides economic benefits to states and health providers. Medicaid expansion has enhanced access to healthcare services. Studies have shown improved self-reported health following expansion and an association between expansion and certain positive health outcomes. Expanding Medicaid has been associated with significant declines in mortality related to specific conditions, including various types of cancer, cardiovascular disease, and liver disease. Additionally, studies have found decreased maternal mortality and, in some cases, reductions in infant mortality among certain populations. Beginning in
2520-665: The average difference in reimbursement for 10 common orthopedic procedures in the states of New Jersey and Delaware was $ 3,047. The discrepancy in the reimbursements Medicaid offers may affect the type of care provided to patients. In general, Medicaid plans pay providers significantly less than commercial insurers or Medicare would pay for the same care, paying around 67% as much as Medicare would for primary care and 78% as much for other services. This disparity has been linked to lower provider rates of participation in Medicaid programs vs Medicare or commercial insurance, and thus decreased access to care for Medicaid patients. One component of
2590-514: The cost of expansion was $ 6,366 per person for 2015, about 49 percent above previous estimates. An estimated 9 to 10 million people had gained Medicaid coverage, mostly low-income adults. The Kaiser Family Foundation estimated in October 2015 that 3.1 million additional people were not covered in states that rejected the Medicaid expansion. In some states that chose not to expand Medicaid, income eligibility thresholds are significantly below 133% of
2660-592: The cost of living in a nursing home for those who are eligible; the recipient also pays most of his/her income toward the nursing home costs, usually keeping only $ 66.00 a month for expenses other than the nursing home. Some states operate a program known as the Health Insurance Premium Payment Program (HIPP). This program allows a Medicaid recipient to have private health insurance paid for by Medicaid. As of 2008 relatively few states had premium assistance programs and enrollment
2730-508: The cost of private coverage. Certain groups of people, such as migrants, face more barriers to health care than others due to factors besides policy, such as status, transportation and knowledge of the healthcare system (including eligibility). Medicaid eligibility policies are very complicated. In general, a person's Medicaid eligibility is linked to their eligibility for Aid to Families with Dependent Children (AFDC), which provides aid to children whose families have low or no income, and to
2800-472: The estate of deceased beneficiaries the long-term-care-related costs paid by Medicaid, and gives states the option of recovering all non-long-term-care costs, including full medical costs. Medicaid also offers a Fee for Service (Direct Service) Program to schools throughout the United States for the reimbursement of costs associated with the services delivered to students with special education needs. Federal law mandates that children with disabilities receive
2870-422: The exact qualifications vary by state. Medicaid spent $ 215 billion on such care in 2020, over half of the total $ 402 billion spent on such services. Of the 7.7 million Americans who used long-term services and supports in 2020, about 5.6 million were covered by Medicaid, including 1.6 million of the 1.9 million in institutional settings. Medicaid covers healthcare costs for people with low incomes, while Medicare
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2940-478: The federal poverty line qualifies for Medicaid coverage under the provisions of the ACA. A 2012 Supreme Court decision established that states may continue to use pre-ACA Medicaid eligibility standards and receive previously established levels of federal Medicaid funding; in states that make that choice, income limits may be significantly lower, and able-bodied adults may not be eligible for Medicaid at all. Medicaid
3010-482: The federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. Medicaid was established in 1965, part of the Great Society set of programs during President Lyndon Johnson’s Administration , and was significantly expanded by the Affordable Care Act (ACA), which was passed in 2010. In most states, any member of a household with income up to 138% of
3080-572: The federal level and focuses primarily on the older population. Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and (through the End Stage Renal Disease Program ) people of all ages with end-stage renal disease . The Medicare Program provides a Medicare part A covering hospital bills, Medicare Part B covering medical insurance coverage, and Medicare Part D covering purchase of prescription drugs . Medicaid
3150-426: The form of waivers for certain Medicaid requirements so long as they follow certain objectives. In its implementation, this has meant using Medicaid funds to pay for low-income citizens' health insurance; this private-option was originally carried out in Arkansas but was adopted by other Republican-led states. However, private coverage is more expensive than Medicaid and the states would not have to contribute as much to
3220-497: The generalized hypothesis that Democrats favor generous eligibility policies while Republicans do not. When the Supreme Court allowed states to decide whether to expand Medicaid or not in 2012, northern states, in which Democratic legislators predominated, disproportionately did so, often also extending existing eligibility. Certain states in which there is a Republican-controlled legislature may be forced to expand Medicaid in ways extending beyond increasing existing eligibility in
3290-483: The law to comprehensive preventive and restorative dental services, but dental care utilization for this population is low. The reasons for low use are many, but a lack of dental providers who participate in Medicaid is a key factor. Few dentists participate in Medicaid – less than half of all active private dentists in some areas. Cited reasons for not participating are low reimbursement rates, complex forms and burdensome administrative requirements. In Washington state,
3360-429: The law was passed, some states did not allow able-bodied adults to participate in Medicaid, and many set income eligibility far below the Federal poverty level. Under the provisions of the law, any state that participated in Medicaid would need to expand coverage to include anyone earning up to 138% of the Federal poverty level beginning in 2014. The costs of the newly covered population would initially be covered in full by
3430-809: The mid-1800s, and much of the language can be traced back to the Pauper Act of 1901. San Francisco Proposition N of 2002 , colloquially known as Care Not Cash, was a San Francisco ballot measure sponsored by Supervisor Gavin Newsom designed to cut the money given in the General Assistance programs to homeless people in exchange for shelters and other forms of services. County indigent medical programs can be categorized as County Medical Services Program (CMSP) and Medically Indigent Service Program (MISP) counties. There are 34 CMSP counties and 24 MISP counties. The CMSP county programs are largely managed by
3500-632: The national average per capita annual cost of Medicaid services for children to be $ 2,577, adults to be $ 3,278, persons with disabilities to be $ 16,859, aged persons (65+) to be $ 13,063, and all Medicaid enrollees to be $ 5,736. The Social Security Amendments of 1965 created Medicaid by adding Title XIX to the Social Security Act , 42 U.S.C. §§ 1396 et seq. Under the program, the federal government provided matching funds to states to enable them to provide Medical Assistance to residents who met certain eligibility requirements. The objective
3570-620: The national uninsured population lives in those states. As of March 2023, 40 states have accepted the Affordable Care Act Medicaid extension, as has the District of Columbia , which has its own Medicaid program; 10 states have not. Among adults aged 18 to 64, states that expanded Medicaid had an uninsured rate of 7.3% in the first quarter of 2016, while non-expansion states had a 14.1% uninsured rate. The Centers for Medicare and Medicaid Services (CMS) estimated that
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#17327811232093640-459: The new CalEITC). A 1 percentage point reduction (about 380,000 Californians) is attributable to CalWORKs . Similar effects are achieved by nation-wide programs. Using the SPM, tax credits achieve a 2.5 percentage point reduction in the poverty rate, and SNAP (of which CalFresh is a part), SSI , and housing subsidies each achieve a 1 percentage point reduction (about 3,300,000 U.S. residents each). Only
3710-592: The payment of rent assistance to private landlords on behalf of low-income households, as well as overseeing Community Development Block Grant (CDBG) entitlements and HOME Investment Partnerships Program (HOME) funding. Local housing authorities were created following the 1 September 1937 signing by President Franklin D. Roosevelt of the Housing Act of 1937 , sometimes called the Wagner-Steagall Act, which provided for subsidies to be paid from
3780-466: The population was enrolled in Medi-Cal for at least 1 month in 2009–10. As of 2017, the total annual cost of Medicaid was just over $ 600 billion, of which the federal government contributed $ 375 billion and states an additional $ 230 billion. According to CMS, the Medicaid program provided health care services to more than 92 million people in 2022. Loss of income and medical insurance coverage during
3850-446: The poverty line were eligible for Medicaid, those with incomes from 32% to 100% of the poverty level ($ 6,250 to $ 19,530 for a family of three) were ineligible for both Medicaid and federal subsidies to buy insurance. Studies of the impact of Medicaid expansion rejections calculated that up to 6.4 million people would have too much income for Medicaid but not qualify for exchange subsidies. Several states argued that they could not afford
3920-464: The poverty line. Some of these states do not make Medicaid available to non-pregnant adults without disabilities or dependent children, no matter their income. Because subsidies on commercial insurance plans are not available to such individuals, most have few options for obtaining any medical insurance. For example, in Kansas , where only non-disabled adults with children and with an income below 32% of
3990-463: The program, although all have since 1982. In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities . As of 2022 45% of those receiving Medicaid or CHIP were children. Medicaid also covers long-term services and supports, including both nursing home care and home- and community-based services, for those with low incomes and minimal assets;
4060-571: The proportion of hospital stays for children paid by Medicaid increased by 33% and the proportion paid by private insurance decreased by 21%. Some 43 million Americans were enrolled in 2004 (19.7 million of them children) at a total cost of $ 295 billion. In 2008, Medicaid provided health coverage and services to approximately 49 million low-income children, pregnant women, elderly people, and disabled people. In 2009, 62.9 million Americans were enrolled in Medicaid for at least one month, with an average enrollment of 50.1 million. In California , about 23% of
4130-424: The recovery is limited to probate estates or extends beyond.) Several political factors influence the cost and eligibility of tax-funded health care. According to a study conducted by Gideon Lukens, factors significantly affecting eligibility included "party control, the ideology of state citizens, the prevalence of women in legislatures, the line-item veto, and physician interest group size". Lukens' study supported
4200-588: The resources required to meet their basic needs (a poverty threshold varying based on factors such as family size and local cost-of-living) to label them as "in" or "out" of poverty, and thus determine a poverty rate for the state. Several such measures are calculated, including the Census Bureau 's Supplemental Poverty Measure (SPM) and the Public Policy Institute of California's California Poverty Measure (CPM). The current CPM poverty rate
4270-623: The same basic framework. As of 2013, Medicaid is a program intended for those with low income, but a low income is not the only requirement to enroll in the program. Eligibility is categorical —that is, to enroll one must be a member of a category defined by statute; some of these categories are: low-income children below a certain wage, pregnant women, parents of Medicaid-eligible children who meet certain income requirements, low-income disabled people who receive Supplemental Security Income (SSI) and/or Social Security Disability (SSD), and low-income seniors 65 and older. The details of how each category
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#17327811232094340-1442: The same organization that handles Medicaid in a state may also manage the additional programs. Separate programs may also exist in some localities that are funded by the states or their political subdivisions to provide health coverage for indigents and minors. State participation in Medicaid is voluntary; however, all states have participated since 1982. In some states Medicaid is subcontracted to private health insurance companies, while other states pay providers (i.e., doctors, clinics and hospitals) directly. There are many services that can fall under Medicaid and some states support more services than other states. The most provided services are intermediate care for mentally disabled, prescription drugs and nursing facility care for under 21-year-olds. The least provided services include institutional religious (non-medical) health care, respiratory care for ventilator dependent and PACE (inclusive elderly care ). Most states administer Medicaid through their own programs. A few of those programs are listed below: As of January 2012, Medicaid and/or CHIP funds could be obtained to help pay employer health care premiums in Alabama , Alaska , Arizona, Colorado , Florida , and Georgia . States must comply with federal law, under which each participating state administers its own Medicaid program, establishes eligibility standards, determines
4410-462: The saving on to patients currently without adequate dental care. While Congress and the Centers for Medicare and Medicaid Services (CMS) set out the general rules under which Medicaid operates, each state runs its own program. Under certain circumstances, an applicant may be denied coverage. As a result, the eligibility rules differ significantly from state to state, although all states must follow
4480-684: The scope and types of services it will cover, and sets the rate of reimbursement physicians and care providers. Differences between states are often influenced by the political ideologies of the state and cultural beliefs of the general population. The federal Centers for Medicare and Medicaid Services (CMS) closely monitors each state's program and establishes requirements for service delivery, quality, funding, and eligibility standards. Medicaid estate recovery regulations also vary by state. (Federal law gives options as to whether non-long-term-care-related expenses, such as normal health-insurance-type medical expenses are to be recovered, as well as on whether
4550-475: The so-called Medicaid coverage gap in states that have not expanded Medicaid: there are people whose income is too high to qualify for Medicaid in those states, but too low to receive assistance in paying for private health insurance, which is therefore unaffordable to them. States may bundle together the administration of Medicaid with other programs such as the Children's Health Insurance Program (CHIP), so
4620-581: The state, whereas MISP counties manage their own programs with their own rules and regulations. Many patients from both the CMSP and MISP county programs are expected to transition to county LIHP / MCE / HCCI programs and eventually to Medi-Cal / Medicaid when the ObamaCare provisions take effect in 2014. City and county-based housing authorities manage the Housing Choice Voucher program for
4690-666: Was designed and developed in collaboration with C-IV to eventually consolidate LRS and C4Yourself into a single system. The California Budget Act of 1995 had required the Health and Welfare Agency Data Center (now the California Office of Systems Integration ), in collaboration with the County Welfare Directors Association , to develop a plan to consolidate the systems to no more than four county consortia; ABX1 of 2011 required OSI to oversee
4760-520: Was relatively low. Interest in this approach remained high, however. Included in the Social Security program under Medicaid are dental services . Registration for dental services is optional for people older than 21 years but required for people eligible for Medicaid and younger than 21. Minimum services include pain relief, restoration of teeth and maintenance for dental health. Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
4830-450: Was the California implementation of the federal Children's Health Insurance Program (CHIP) that provided low-cost insurance that provides health, dental, and vision coverage to children who do not have insurance and do not qualify for no-cost Medi-Cal. As a result of the 2012–2013 budget deal, the HFP was discontinued and Medi-Cal requirements were lowered so that HFP patients would qualify for Medi-Cal. Nearly 900,000 children were moved from
4900-524: Was to help states assist residents whose income and resources were insufficient to pay the costs of traditional commercial health insurance plans. By 1982, all states were participating. The last state to do so was Arizona. The Medicaid Drug Rebate Program and the Health Insurance Premium Payment Program (HIPP) were created by the Omnibus Budget Reconciliation Act of 1990 (OBRA-90). This act helped to add Section 1927 to
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