The future of Medicaid -- the state-federal workhorse of the nation's health system that provides health coverage to the poorest and sickest Americans -- hangs in the balance on Election Day.
President Barack Obama and Republican nominee Mitt Romney have vastly different approaches to the program. Medicaid is the backbone of the 2010 health law -- considered Obama's signature legislative achievement -- which, starting in 2014, expands coverage to 30 million uninsured Americans. As many as 17 million of those newly insured citizens will be on Medicaid. Romney would turn over much control of the program to states and give them new powers to tailor benefits and eligibility to their own budget needs. Romney says such a move would begin saving $100 billion per year by 2016.
The following list of "frequently asked questions" provides more details on the presidential candidates' plans for Medicaid.
Tune in to the PBS NewsHour on Monday evening for Hari Sreenivasan's full report on the role Medicaid plays in the U.S. health care system -- especially for seniors living in nursing care facilities -- and how the proposals outlined by the candidates could impact the program.
What is Medicaid?
Created in 1965, Medicaid is jointly financed by the federal government and the states. States administer the program but the federal government sets minimum income and eligibility thresholds, targeting low-income children and their parents, the elderly and people with disabilities. It also sets minimum benefits that state Medicaid plans must provide. States can build on these requirements and, as a result, eligibility rules vary widely. The program now covers about 60 million Americans, of which about half are children. Medicaid pays for nearly two-thirds of nursing home residents and about 40 percent of births.
Medicaid is an open-ended entitlement program in which the federal government matches state spending on health insurance. Match rates range from 50 percent to 73 percent, depending on a state's per capita income, with poorer states receiving higher rates. The average federal match is 57 percent.
How does President Obama's health care reform law change Medicaid?
The 2010 law eliminates varying eligibility rules and, starting in 2014, provides Medicaid coverage to everyone with incomes less than 133 percent of the federal poverty level, which today is nearly $31,000 for a family of three.
This expansion could add as many as 17 million people to Medicaid over the next decade if all states adopt the change. Most of the newly eligible would be adults without children who currently are not covered in most states.
The Supreme Court ruling which upheld the health care reform law made this expansion optional for states. Several Republican governors have already said they would not take the extra federal money to expand the program.
Under the law, the federal government pays the full cost for those newly eligible for Medicaid from 2014 to 2016, then states have to begin to contribute to the cost but no more than 10 percent by 2020. States will receive their current federal funding match rate for people currently eligible.
Below you will find links to voting with disabilities from national organizations.
Disability Vote Project: American Association of People with Disabilities
The AAPD Disability Vote Project (DVP) addresses the fundamental inequalities faced by voters with disabilities, and works in a nonpartisan approach to ensure full accessibility to all polling places and voting equipment.
DVP’s work:
- Eliminating barriers to voting
- Promoting voter turnout in the disability community
- Ensuring that voting the voting machines in production are accurate, accessible, and secure
- Growing disability vote coalitions across the country
- Educating the disability community on the importance of voting
- Increasing the registration rate among voters with disabilities
Disability and Voter Turnout
Fact sheets and testimony:
- “Fact sheet: Disability and Voter Turnout in the 2010 Elections,” by Lisa Schur and Douglas Kruse, June 2011.
- “Fact sheet: Disability and Voter Turnout in the 2008 Elections,” by Lisa Schur and Douglas Kruse, July 2009.
- “Testimony before Election Assistance Commission,” October 8, 2009. By Lisa Schur. Webcast at http://www.yorkmedia.com/eac/webcasts2009.htm.
- Studies:
- “Sidelined or Mainstreamed? Political Participation and Attitudes of People with Disabilities in the United States,” Presented at the American Political Science Association conference, August 2008, and updated October 2009. By Lisa Schur and Meera Adya.
- “Voting,” in Gary Albrecht, ed., Encyclopedia of Disability (Thousand Oaks, CA: Sage Publications, 2005). By Lisa Schur, Todd Shields, and Kay Schriner.
- “Enabling Democracy: Disability and Voter Turnout,” Political Research Quarterly, Vol. 55, No. 1, March 2002, pp. 167-190. By Lisa Schur, Todd Shields, Douglas Kruse, and Kay Schriner.
- “What Determines Voter Turnout? Lessons from Citizens with Disabilities,” Social Science Quarterly, Vol. 81, No. 2, June 2000, pp. 571-587. ByLisa Schur and Douglas Kruse.
The Arc: We've Got the Power Vote in 2012
Election Day 2012—it’s closer than you think! In this time of rapid change and challenges at all levels of government, the importance for action by people with intellectual & developmental disabilities (I/DD), their families, and everyone who cares about our issues, and to become engaged in the political process has never been more important.
The Arc is pleased to provide resources for advocates and community partners for the upcoming 2012 elections. As people who care about the dignity, civil rights and access for people with I/DD at all levels of society, it is our role to promote civic responsibility and participation in our democracy. The Arc is launching its “We’ve Got The Power!” campaign to amplify the voice of people with disabilities as active participants in the political process, and in their communities. Together with Nonprofit Vote, a nonpartisan organization focused on providing voter engagement tools and resources, The Arc is providing links to toolkits, checklists, and other important resources for those wishing to show our communities that “We’ve Got the Power!” It’s time to Make Our Mark in 2012!
Bazelon Center 2012 Voting Rights Guides
Highlighted Tools
Handouts and Flyers for Posting in Facilities and at Polls
Additional Resources
Below you will find links to voting with disabilities information from each state.
from USA Today by Catalina Camia:
The only woman in the House Republican leadership team reportedly is open to being Mitt Romney's running mate and would like to see a woman on the ticket.
Rep. Cathy McMorris Rodgers, R-Wash., vice chairwoman of the House GOP Conference, acknowledged her interest in being Romney's No. 2 in an interview with National Review. She was first elected to the House in 2005.
She said she's not "seeking" to be picked -- and even admirers say she's a long shot -- and wants Romney to choose a conservative and, if possible, a woman.
"Republican women bring an important voice to the table," McMorris Rodgers is quoted as saying. "The big issues that face this country right now — the economy, jobs, the debt, and health care — are on the forefront of people's minds, and especially on women's minds."
The veepstakes have begun in earnest and have taken on the aura of a reality TV show. As USA TODAY's Susan Page reports today, some of Romney's potential running mates are making big speeches, promoting books and are essentially doing "tryouts" in joint appearances with the presumptive GOP nominee.
Sen. Kelly Ayotte, R-N.H., who is sometimes mentioned as a potential VP choice, was on the campaign trail yesterday with Romney. Her stock went up today on Intrade, where she's now given a 4.4% chance of being the nominee. (Florida Sen. Marco Rubio and Ohio Sen. Rob Portman are tops on Intrade.)
