What is the Medicaid Program?
Medicaid is the nation’s public health insurance program for people with low income. The Medicaid program plays a critical role in meeting the health coverage needs of people with low income, children, pregnant people, the elderly, and people with disabilities across the country.
The Medicaid program is funded by both federal and state governments with flexibility given to states in how to administer the program within federal guidelines. As a result, Medicaid eligibility and benefits often vary from state to state. Medicaid is the single largest health insurer in the United States, covering a range of services including long-term care (unlike Medicare and commercial health insurance), comprehensive benefits for children, and mental health and substance use treatment services.
Key Facts about the Medicaid Program:
Why It Matters
Medicaid is vital in providing economic security to families and communities. It helps families pay their bills, stay healthy, and get the treatment and care they need and deserve.
Approximately 1 in 3 Kentuckians rely on Medicaid Coverage
Approximately 1 in 5 Tennesseans rely on Medicaid Coverage
Approximately 1 in 4 Ohioans rely on Medicaid Coverage
Approximately 1 in 3 West Virginians rely on Medicaid Coverage
How does the Medicaid Program
Many Appalachians have benefited from Medicaid since several states have adopted Medicaid expansion, such as Kentucky, Ohio, and West Virginia. This expanded eligibility beyond traditional Medicaid eligibility groups (children, pregnant people, parents, seniors, and individuals with disabilities) to people whose household income in below 138 percent of the federal poverty line. Not only does Medicaid expansion adoption allow for more people to gain coverage, but it also allows the state to increase its federal match rate to enable the state to provide the necessary benefits to this expanded population and avoid state budget shortfalls.
Medicaid expansion has allowed for several states in Appalachia to maintain critical health care infrastructure, especially in rural regions of Appalachia.
However, some states in Appalachia – such as Tennessee – have yet to expand Medicaid and are now experiencing worsening racial health disparities, rural hospital closures, and many Appalachians unable to access the health care they need.
Thanks to Medicaid expansion, Appalachians in expansion states have experienced:
Medicaid and Telemedicine
Prior to the COVID-19 pandemic, telemedicine was proposed as a solution to the disparities in providers physically accessible to many rural Appalachian residents. These disparities range from primary care providers (12 percent fewer primary care providers per 100,000 residents in Appalachia than in the country overall) to mental health providers (35 percent fewer mental health providers per 100,000 residents in Appalachia than in the country overall). Beyond expanding the number of providers to people in rural Appalachia, telemedicine also addresses the transportation obstacles that people in rural Appalachia disproportionately face when seeking an appointment with a health care provider. Telemedicine bridges the gaps in accessing needed care for Appalachians and recent Medicaid policies have encouraged its expansion.
The COVID-19 pandemic has made telehealth an even more favorable avenue for expanding access to care for Appalachians. Many states in the Appalachian region have expanded telemedicine coverage through Medicaid in response to the pandemic, allowing many Appalachians to consult with health care providers from the comfort of their own home.
While telemedicine is highly advantageous for many people living in rural Appalachia, it requires the technology to be able to communicate with a heath care provider and an internet connection. Households in the Appalachian region are less likely to have these requisites, making access to telemedicine an obstacle in and of itself.