Medicaid was created in 1965 as a federal and state program to support the medical costs of low-income individuals. The Medicaid program has continually evolved in size and scope, today serving as a principal insurer for individuals with a complex array of health care and social needs, including pregnant women, elderly adults, people with disabilities, and children. Medicaid provides health insurance coverage for over 70 million individuals,—representing more than 20% of the population. Medicaid spending grew 2.9% to $581.9 billion in 2017, or 17% of national health expenditures. Medicaid is the principal provider of long-term care coverage, covering 45% of non-elderly adults with disabilities, and more than 60% of residents in nursing homes. Together with the Children’s Health Insurance Program (CHIP), it also covers 48% of children with special health care needs, ranging from Down Syndrome to Autism to emotional trauma.
At the helm of the program are 56 state Medicaid Directors, who are the individuals responsible for administering the program in the 50 states, the District of Columbia, and the five U.S. territories. Because they are accountable for up to 30% of state budgets, Medicaid Directors are acutely focused on managing the costs, quality, and growth of the program. As such, they work to provide high-quality health care to millions of vulnerable individuals, as well as proper, transparent, and accountable stewardship of taxpayer dollars.
Each year, NAMD administers its Operations Survey to Medicaid Directors and presents the information collected in an annual Operations Survey report. Now in its seventh year, the Annual Operations Survey report provides a look into Medicaid operations from the Medicaid Director’s perspective.