Medicaid is the nation's public health insurance program for low-income Americans, covering 59 million low-income children, families, seniors, and people with disabilities. The program is a federal-state partnership that provides coverage based on income levels and eligibility categories. Medicaid beneficiaries are much poorer and in markedly worse health than the privately insured population. Medicaid is designed as a safety net during difficult economic times, but when states encounter budget shortfalls as enrollees increase, it becomes difficult. About 14 percent of the nonelderly population is covered by Medicaid, making it the largest provider of health insurance.

Medicaid guidelines specify four main categories of the nonelderly low-income individuals that it will cover: children, their parents, pregnant women, and individuals with disabilities, but this still leaves 35 percent of those below the poverty line with no insurance. Over the past decade, growth in Medicaid enrollment has helped buffer losses in job-based coverage.

Medicaid and SCHIP cover more than one-quarter of all children and a little more than half of low-income children. SCHIP was created in 1997 to expand coverage for children who were caught in a middle ground (and the 2009 federal budget provided for further expansion of the program). Their families were not desperate enough for Medicaid, but they could not afford basic health care without government help.

While Medicaid covers the bulk of low-income children in the United States, SCHIP is designed to supplement Medicaid by covering children whose family income is too high to qualify for Medicaid. Between Medicaid and SCHIP, half of all low-income families are covered. But lack of understanding of the programs means that many who are eligible are still not taking advantage of them.

Medicaid for those with disabilities is limited to those with very low incomes and few assets but is available for people with conditions like HIV/AIDS. . .

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