Medicaid: 35 years of service

On this 35th anniversary of the enactment of Medicaid, it is important to r eflect on the program's role in the U.S. health care system. The Medicaid p rogram is the third largest source of health insurance in the United States -after employer-based coverage and Medicare. The significance of Medicaid's role in providing health insurance cannot be overstated As the largest in the Federal safety net of public assistance programs, Medicaid provides ess ential medical and medically related services to the most vulnerable popula tions in society. In 1998, the Medicaid program covered 41.4 million(1) low -income children, their families, elderly people, and individuals with disa bilities-approximately 12 percent of the total U.S. population.(2) Since its inception in 1965, Medicaid enrollment and expenditures have grow n substantially, In addition, the Program has evolved as Federal and State governments balance social, economic, and political factors affecting this and other public assistance programs. This article presents an overview of the Medicaid program and highlights trends in enrollment and expenditures.