Medicaid is a jointly funded state and federal health insurance program that provides affordable basic health services for over 70 million low-income Americans – including one third of people living with epilepsy. Each state administers their own Medicaid program according to certain parameters issued by the Centers for Medicare and Medicaid Services (CMS). CMS is a federal agency within the Department of Health and Human Services. They create policy guidelines, rules, and standards that states must meet; states retain considerable flexibility and control of covering other populations and services not required under federal law.
Federal law requires states to cover certain services, such as inpatient and outpatient hospital services, physician services, and laboratory services, for low-income people, families and children, pregnant women, elderly adults, and people with disabilities based on an income threshold. Some state programs cover additional populations and services including prescription drugs, case management, home and community-based services, and physical therapy.
The Foundation is committed to ensuring that Medicaid provides adequate, affordable, and accessible health care coverage for people living with epilepsy.
The Affordable Care Act (ACA) allowed states to expand Medicaid eligibility to all individuals with household income below 138 percent of the federal poverty line and receive significant federal funds to pay for these new beneficiaries.
There are currently 37 states, including DC, that have adopted to expand Medicaid to bridge the coverage gap - improving access to affordable health care coverage, medical services, and medications.