Enacted in 1965 as Title XIX of the Social Security Act, Medicaid is a means-tested entitlement program that finances of primary and acute medical services as well as long-term care to more than 55 million people. As an entitlement program, all people who meet Medicaid’s eligibility criteria are eligible to enroll and receive services; enrollment caps and waiting lists for benefits are not allowed. Medicaid covers some federally mandated low-income populations, including pregnant women and young children, children and adults with diverse physical and mental health conditions and disabilities, and poor elderly and disabled Medicare beneficiaries. Eligibility varies widely among states because, although states must meet federal minimum requirements, states may also choose to cover additional optional populations. Medicaid’s expansion under the Affordable Care Act puts the program in the spotlight as states decide whether to cover additional people under the program.
States, in partnership with the federal government, have provided low-income children with health insurance coverage for more than a decade through the Children's Health Insurance Program (CHIP). CHIP was created to bridge the safety net gap for low-income children who do not qualify for Medicaid but whose families cannot afford insurance. Nearly 8 million children up to age 19 receive free or low-cost health coverage through the program.