Abstract and Keywords
This chapter examines the evolution of Medicaid as a component of U.S. healthcare financing. It begins with an overview of Medicaid’s aims, parameters, and impact on health and healthcare, with particular emphasis on how Medicaid developed into an indispensable mechanism for financing healthcare for patients and treatments excluded by both private health insurance and Medicare. It then considers the significance of Congress’s decision to rest health reform for the poor on Medicaid and discusses three fundamental challenges faced by the program: the politics of size, scope, and power-sharing; aligning Medicaid with the broader aims of health reform; and preserving access to the courts by private individuals who claim that state conduct violates federal rights and protections. The chapter concludes with an assessment of the future of Medicaid.
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